What Comes after an Abnormal Pap Smear?

The Pap smear was developed in 1928 by George Papanicolaou and has become one of the fastest, easiest, and most effective ways to detect cervical cancer early on. It’s now a routine test done for most 21–65-year-old women every three years, and it saves many lives. 

At Physicians for Women in Madison, Wisconsin, our team of reproductive health specialists are committed to early detection practices to reduce your health risks and keep you going strong. Pap smears are done every three years at the time of your yearly gynecological exam, and if you have an abnormal result, we’ll immediately follow up with you.

What a Pap smear checks for

The Pap smear checks for abnormal cervical cells, which are usually caused by human papillomavirus (HPV). Abnormal changes in the cervical tissue can lead to the development of cancer cells. A Pap smear every three years can detect changes in cervical tissue in the early stages, and when detected early, cervical cancer is highly treatable. 

In fact, regular Pap smears combined with HPV vaccination can prevent an estimated 93% of cancer cases. Sadly, only around 69% of women, though, stay up to date on their Pap smears. How long has it been since you’ve gotten a Pap? If the answer is “more than three years,” it’s time to call our office and schedule an exam.

At Physicians for Women, we use the ThinPrep Pap Test, which is the most effective and widely used test available and has been proven to increase early detection of precancerous cells.  

Most abnormal Pap smear results are nothing to worry about

Most women will have at least one abnormal Pap smear result in their lifetime, with an overall average of 5% of all Pap tests coming back as “abnormal.” In most cases, the abnormal result is nothing to worry about, but it’s important to follow up to make sure. 

If your Pap smear comes back with signs of changes to your cervical tissue, we’ll notify you and help you navigate the next steps.

HPV testing

If you are age 21 to 29, and you have an abnormal Pap result, your doctor will call you in for an HPV screening, which looks for signs of high-risk HPV that could cause cancer. This test is extremely accurate and can typically tell us whether or not you are at high risk for cervical cancer. If you are age 30 to 65, we co-test, which means we perform an HPV test at the same time as your Pap smear.

If your HPV test comes back negative, we’ll note the abnormal Pap smear in your file and may add a Pap to your next annual well woman exam instead of the usual three year interval between Pap smears, so we can track your results. If the HPV test comes back positive, we’ll discuss what types of HPV infections we found. 

Treatment for abnormal cells

An abnormal Pap result combined with a positive HPV test usually doesn’t mean you have cancer, only that cancer is a potential future threat. 

We may do a follow-up colposcopy (inspection of the cervix) to check and see if your cellular abnormalities are resolving on their own, as many women can clear HPV without outside interference. If the abnormalities have progressed, your doctor may perform LEEP (loop electrosurgical excision procedure) to remove affected tissue. This treatment can be done in our office.  

Bottom line? If you have an abnormal Pap smear, don’t panic. Your odds are good that it’s going to be fine, and your body will resolve the issue on its own. And we’ll be there to help you every step of the way. 

Want more information about Pap smears, HPV, or cancer prevention? Contact our office at 608-218-4825, or book an appointment online.