Abnormal Pap Smear Results
An abnormal Pap smear can feel frightening, but an abnormal result does not mean you have cervical cancer. Our goal is to help you understand your results, identify the appropriate follow-up, and provide thoughtful care every step of the way.
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Abnormal does not automatically mean cancer.
Most abnormal cervical screening results are related to HPV infection or early cervical cell changes that can be monitored or treated before cervical cancer develops.
What does an abnormal Pap smear mean?
A Pap test looks for changes in the cells of the cervix. An abnormal result means that some cells looked different from normal cells. It does not, by itself, diagnose cancer.
Cell changes can be temporary
Cervical cell changes are often associated with human papillomavirus (HPV), and many mild changes resolve on their own without treatment.
HPV is very common
Certain high-risk types of HPV can cause cervical cell changes. Having HPV does not mean that you have cancer.
Follow-up matters
Your recommended next step depends on your specific screening result, age, and previous screening history.
Common abnormal Pap results
Pap test reports use specific terms to describe the appearance of cervical cells. Your doctor will interpret your result together with HPV testing and your previous screening history.
ASC-US
Atypical Squamous Cells of Undetermined Significance
Some squamous cells do not look completely normal, but it is unclear why. HPV testing may help determine what follow-up is appropriate.
LSIL
Low-Grade Squamous Intraepithelial Lesion
These are mild cervical cell changes, often associated with HPV infection. Depending on your overall risk, your doctor may recommend monitoring or additional evaluation.
HSIL
High-Grade Squamous Intraepithelial Lesion
These changes are more significant and may be associated with precancerous cervical changes. Further evaluation, commonly including colposcopy, may be recommended.
AGC
Atypical Glandular Cells
Abnormalities have been identified in glandular cells. Additional evaluation may be recommended because glandular cells are found in areas beyond the surface of the cervix.
ASC-H
Atypical Squamous Cells — Cannot Exclude HSIL
The cells show changes that raise concern for a high-grade lesion. Your physician may recommend additional evaluation, such as colposcopy.
AIS
Adenocarcinoma in Situ
AIS involves abnormal glandular cells and requires careful evaluation and management by your gynecologic care team.
HPV and abnormal Pap results
Human papillomavirus is a very common infection. Certain high-risk HPV types are associated with cervical cell changes that can eventually lead to cervical cancer.
A positive high-risk HPV test does not mean that you currently have cervical cancer. Instead, it can help your healthcare provider determine whether additional testing or monitoring is appropriate.
HPV infection is common.
A positive HPV test does not automatically mean cancer.
Follow-up depends on your individual risk.
What happens after an abnormal Pap?
There is no single follow-up plan for every abnormal result. Your physician considers the current result together with your age and previous screening history.
Review your results
Your physician reviews your Pap result, HPV status, age, and previous screening history.
Determine your risk
Current cervical screening guidance uses risk-based management to determine whether surveillance, additional testing, or colposcopy is appropriate.
Additional testing if needed
Depending on your results, follow-up may include repeat HPV or Pap testing, HPV typing, colposcopy, or biopsy.
Monitor or treat
Mild changes may be monitored, while higher-grade changes may require treatment to remove or destroy abnormal tissue.
What is a colposcopy?
A colposcopy is an examination that allows your physician to look closely at the cervix using a special magnifying instrument called a colposcope.
If an area looks abnormal, a small biopsy may be taken and examined by a laboratory. The biopsy helps determine whether cervical cell changes are present and how significant those changes are.
Learn about cervical evaluationUnderstanding CIN
A cervical biopsy may be described using the term cervical intraepithelial neoplasia, or CIN. CIN describes abnormal cervical cells and is graded according to how significant the changes are.
Mild changes
CIN 1 represents low-grade changes that often resolve without treatment.
Moderate changes
CIN 2 represents moderate changes. Management may depend on individual circumstances and clinical risk.
Severe changes
CIN 3 represents high-grade changes that require appropriate medical management to reduce the risk of progression to cervical cancer.
Treating abnormal cervical cells
Treatment depends on the severity and location of the cervical cell changes, your medical history, and other individual factors.
LEEP
A loop electrosurgical excision procedure uses a thin wire loop to remove abnormal cervical tissue.
Conization
A cone-shaped section of cervical tissue containing abnormal cells may be removed for evaluation and treatment.
Ablative treatment
In selected situations, abnormal tissue may be destroyed using techniques such as cryotherapy or laser treatment.
An abnormal result is not a diagnosis of cancer.
Abnormal cervical screening results are common. The important step is completing the recommended follow-up so that any significant cervical changes can be identified and managed early.
Abnormal Pap smear FAQ
Does an abnormal Pap smear mean I have cancer?
No. An abnormal Pap result does not automatically mean cervical cancer. It means that some cervical cells look different from normal and that follow-up may be needed.
What causes an abnormal Pap smear?
Many abnormal results are associated with HPV infection. Other factors can also affect how cervical cells appear, including irritation, some infections, hormonal changes, pregnancy, and menopause.
What happens if my HPV test is positive?
A positive high-risk HPV test means that a high-risk type of HPV was detected. It does not mean that you have cancer. Your healthcare provider will determine the appropriate follow-up based on your complete screening history and current results.
Will I need a colposcopy?
Not everyone with an abnormal Pap result needs a colposcopy. The recommendation depends on your current results, HPV status, age, and previous screening history.
What happens during a colposcopy?
A speculum is used to view the cervix. A special solution may be applied to help identify areas that need closer examination. A magnifying instrument called a colposcope is then used to examine the cervix. A biopsy may be taken if an abnormal area is identified.
Can abnormal cervical cells go away?
Yes. Some mild cervical cell changes, particularly low-grade changes, can return to normal without treatment. Your doctor will recommend monitoring or treatment based on your individual risk.
What is CIN?
CIN stands for cervical intraepithelial neoplasia. It is a term used to describe abnormal cervical cells found through biopsy and is generally graded from CIN 1 to CIN 3.
Can abnormal Pap results be treated?
Some higher-grade cervical changes can be treated by removing abnormal tissue or, in selected situations, destroying the abnormal tissue. Treatment recommendations depend on the specific diagnosis and individual circumstances.
Don't face your results alone.
If you've received an abnormal Pap smear or HPV result, we can help you understand what it means and what your next step may be.
Medical information: This page is provided for general educational purposes and is not a substitute for personalized medical advice, diagnosis, or treatment. Cervical screening recommendations and follow-up depend on individual circumstances, including age, current results, HPV status, and previous screening history. Please discuss your specific results with your healthcare professional.