Abnormal Pap Results: What to Expect at Your Follow-Up Colposcopy

Most Pap test results are normal, and most abnormal Pap test results don’t mean you have cervical cancer. But if your results come back positive, it’s best to be sure with a colposcopy. Here’s what to expect.

One of the best screenings for cervical cancer is the Pap test, also known as the Pap smear. While it doesn’t top any woman’s list of desirable experiences, it’s a useful tool for detecting cervical cancer.

The Pap test is a simple precaution that usually comes back “normal.” For the few who receive abnormal results, the news can be distressing, but not if you know the truth: The medical director of the Women’s Health Center, Johns Hopkins Outpatient Center and co-director of the Johns Hopkins Colposcopy Clinic states that “Most women [with abnormal Pap results] do not have cancer.”

And we agree.

Board-certified OB/GYN Dr. Anju Nayar and our Nova Women’s Health team in North Reading, Massachusetts, know that abnormal Pap smears are nothing to panic about, but they do require a follow-up to ensure all is well. That’s what a colposcopy does. Here’s what you should know.

What does an abnormal Pap smear mean?

Every three years, between the ages of 21 and 29, a Pap smear is a routine part of your well-woman exam at Nova Women’s Health. When you turn 30, we add the human papillomavirus (HPV) test to your Pap smear because HPV causes most cases of cervical cancer.

During a quick, painless Pap test, we swab your cervix to grab a sample of the cells and send it to the lab to look for abnormal cells and cells that have changed since the last time we checked. The results return as:

Normal or negative: Everything is OK
Unsatisfactory: There weren’t enough cells for the lab to analyze, or they were clumped together
Abnormal or positive: You have a few cells that don’t look like the others

Only 3.8% of Pap smear results are abnormal, but most don’t indicate cancer. In fact, most abnormal cells simply indicate a vaginal infection. The Pap smear is just the first in a series of tests and tools we use to ensure your health. The next step is a colposcopy to rule out cancer.

Colposcopy: Why you need it and what it detects

An abnormal Pap smear is the primary reason for a colposcopy, but Dr. Nayar may also recommend one if:

She noticed abnormal cervical structure during a routine pelvic exam
You tested positive for HPV
You have unexplained vaginal bleeding

A colposcopy feels a lot like a Pap smear. Dr. Nayar inserts a speculum into your vagina to hold it open, allowing her to visualize the inner tissues. She applies a special staining solution that causes abnormal cells to stand out under a bright light and magnifying lens.

If she detects abnormal cells, she may opt to perform a cervical biopsy, where she takes a tiny tissue sample from your cervix. You’ll feel a quick “pinch” and may experience cramping and light bleeding for the next few hours and up to a few days. Call us right away if you experience:

Heavy vaginal bleeding (especially if it lasts more than a week)
Foul-smelling vaginal discharge
Cramps or pelvic pain that don’t subside
Fever

We send the tissue sample to the lab and await the results, which take a week or two. If the results show precancerous or cancerous cells, Dr. Nayar discusses your treatment options. Often, we can remove the suspicious cells in the office using cryotherapy, a cone biopsy, or a loop electrosurgical excision procedure (LEEP).

However, more often than not, the results are negative, and Dr. Nayar puts you on a regular schedule of Pap smears and colposcopies to monitor your cervical cells.

Don’t let an abnormal Pap smear scare you. Talk to Dr. Nayar about your test results, a colposcopy, and your many treatment options. Book an appointment online or call Nova Women’s Health today.