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What Does An Abnormal Pap Smear Indicate?

What does an abnormal Pap smear indicate

Table of Contents

HPV causes abnormal growth of cells. A pap smear test is the best diagnosis of cervical cancer. This test checks for the presence of cancer and precancerous cells. If precancerous cells are diagnosed, they can be treated before they get cancer. To do this test, cells are gently removed from the cervix and examined for normal or abnormal growth. Early detection of cancer is the best opportunity to fight it.

Women between the ages of 21 and 65 should have regular Pap smears. How often this is done depends on the person’s health and whether they have had an abnormal Pap smear. There may be some discomfort during the process, but no pain will be in the long run.

Who needs a Pap smear?

Most women over 21 should have a Pap smear because some women are at risk for infection or cancer. If you have the following conditions, the number of tests should be higher:

  • HIV positive
  • Chemotherapy or organ transplants have reduced the body’s immunity

People over the age of 30 who have had three consecutive Pap smears with normal results should ask their doctor to perform the test every five years with HPV screening or human papillomavirus screening. HPV is a virus that causes warts. The primary causes of cervical cancer are HPV types 16 and 18. Having HPV increases the risk of cervical cancer. Women over 65 who have had satisfactory Pap smear tests no longer need the test.

How to prepare for a Pap smear?

In order to perform a Pap smear test, the necessary arrangements must be made with a gynecologist at the annual examination, or the test must be performed independently of the annual examination. If a woman is menstruating during the test, the doctor will set another time for a retest. Because during menstruation, the test result may not be completely correct. Sex, vaginal douching, and using spermicidal contraceptives the day before the test are also likely to interfere with the right result.

In most cases, a Pap smear is also safe in the first 24 weeks of pregnancy, and you have to wait 12 weeks after giving birth and then have a Pap smear. The relaxation of the body during a Pap smear plays an essential role in facilitating the process. So try to stay calm and relaxed with relaxation techniques and deep breathing.

What happens during a Pap smear?

During the test, you should lie on your back, spread your legs, and place your feet’ soles on a special pedal. The doctor inserts a speculum or a medical mirror into the vagina. This device keeps the vagina open and allows access to the cervix. The doctor then takes a sample of cervical cells.

There are several ways to remove this sample. Some doctors use a special spatula, and others use a special spatula and brush. Some doctors also use a cytobrush tool, a spatula, and a brush.

Most women get a little upset during the sampling. The received sample is also taken to the laboratory to check the cells for abnormal growth. It is possible to feel a slight discomfort with abdominal contraction after sampling. In some limited cases, there may be some vaginal bleeding after the biopsy. If the bleeding continues, the next day should talk to the doctor.

Who can consider stopping Pap smears?

Pap smear test can be stopped in the following conditions:

  • After a total hysterectomy: If the hysterectomy was performed because of a non-cancerous disease such as uterine fibroids, you might be able to stop the Pap smear. However, if the hysterectomy was due to precancerous or cervical cancer, your doctor may recommend that you continue your routine Pap smear.
  • Older age: Doctors generally agree that women can stop a Pap test at age 65 if previous cervical cancer tests have been negative.

What increases the risk of an abnormal Pap test?

What increases the risk for an abnormal Pap test

People with the following risk factors are advised to have regular Pap tests:

  • Cigarette smoking
  • HPV infection
  • Multiple sex partners
  • Sexually activity before the age of 18
  • Sexual partners with sexually transmitted diseases
  • Pre-cancer or cancer
  • A personal history of an abnormal Pap test
  • Immune-compromising conditions such as HIV
  • Family history of cervical cancer

Is a Pap smear also used to diagnose HPV?

The main purpose of a Pap smear is to identify the growth status of cells. HPV causes abnormal growth of cells. If abnormal cell growth is detected by Pap smear, the problem can be prevented from developing and spreading. It is also possible to detect HPV by Pap smear.

HPV is caused by sexual intercourse. All women with sex are at risk for HPV and should have a Pap smear at least every three years. This test is not able to diagnose other STDs. In some cases, it can detect abnormal cell growth in other diseases, but it shouldn’t be relied on for that purpose.

Ways to prevent cervical cancer and HPV

The main reason for a Pap smear test is to find abnormal cells before they become cancerous. There are several ways to reduce the risk of HPV and cervical cancer.

Get vaccinated

Because cervical cancer is almost always caused by HPV, most women under 45 should get the HPV vaccine.

Safe sex

Use condoms to prevent HPV and other sexually transmitted infections (STIs).

Schedule an annual checkup

Be sure to see a gynecologist annually.

Get Tested

Schedule a Pap smear as recommended by the doctor.

4 Major Abnormal Pap Smear Results

A positive result does not mean cervical cancer. The meaning of a positive result depends on the type of cells discovered in the test. Test results usually take 1 to 3 weeks to prepare. Four main results that need further investigation include:

  1. ASCUS (Atypical squamous cells of undetermined significance)
  2. Cervical Intraepithelial Neoplasia: CIN1, CIN 2, CIN3
  3. High-grade squamous intraepithelial lesion (HSIL)
  4. Low-Grade Squamous Intraepithelial Lesion

ASCUS (Atypical squamous cells of undetermined significance)

Atypical squamous cells of undetermined significance (ASCUS)  are very thin and flat and grow on a healthy cervix’s surface. In the case of ASCUS, Pap smears show that the squamous cells have become slightly abnormal, but this change does not necessarily indicate the presence of precancerous cells. Using a liquid-based test, the doctor re-analyzes the sample to determine if there are known human papillomavirus or HPV. The virus can cause cancer.

The identified abnormal cells will not be a big concern if no virus exists in the sample. But if the virus is present in the sample, more tests should be done.

Cervical Intraepithelial Neoplasia: CIN1, CIN 2, CIN3

Intraepithelial cervical neoplasia is a precancerous disease in which abnormal cells grow on the surface of the cervix. Inside the epithelium means abnormal cells on the surface of the cervix. The word neoplasia refers to the growth of new cells. Another name for CIN is cervical dysplasia. Most people with CIN do not get cancer. If cancer develops, it takes years, so give the doctor time to find and remove problem areas. Neoplasms are divided into the following categories based on the amount of epithelial tissue:

  • CIN 1 refers to dysplasia that affects about one-third of the thickness of the epithelium
  • CIN 2 refers to abnormal changes in about one-third to two-thirds of the epithelial layer
  • CIN 3, the most severe condition, refers to a condition that affects more than two-thirds of the pithelium.

CIN usually occurs after a woman becomes infected with the human papillomavirus (HPV). It is a virus that is spread through sexual contact. In many cases, the immune system gets rid of the virus. It is estimated that more than 75% of sexually active women become infected with HPV at some point. About 50% of HPV infections occur in women aged 15 to 25. It is not clear exactly why some women develop CIN after being infected with HPV; however, some risk factors include:

  • Woman’s age
  • Smoking cigarettes
  • Using immunosuppressant drugs

Factors that weaken the immune system and increase the risk of HPV infection include:

  • Having sex with several partners
  • Infection with Human Immunodeficiency Virus
  • Sexual activity before the age of 18

High-grade squamous intraepithelial lesion (HSIL)

A high-grade squamous intraepithelial lesion (HGSIL) is a precancerous change in the cervix. This is when there are a lot of precancerous cells that are very different from normal cells. These changes affect only the cells on the surface of the cervix. These are more common in women in their 30s and 40s but can occur at any age.

Low-Grade Squamous Intraepithelial Lesion (LSIL)

Low-level squamous cell epithelial lesion (LSIL) is a common abnormal result on a Pap test. Also known as mild dysplasia. LSIL means that cervical cells show mild abnormalities. LSIL or abnormal Pap smear does not mean cancer.

Pap smears can show precancerous cells and other abnormal changes leading to cervical cancer. This is important because it can treat pre-cancer to prevent cervical cancer. Most often, cervical cancer is found in women who do not have regular Pap tests. . Without treatment, HPV can sometimes turn into cervical cancer, which is why treatment is so important.

Treatments for cervical cell changes

Some abnormal changes in the cervix must be removed to prevent cancer. The doctor talks to the patient about which treatment is appropriate.

Cold knife conization

A cervical biopsy is used to diagnose and treat cervical cancer. Abnormal cells that appear on a Pap test may need further examination. There are several types of cervical sampling. Puncture biopsy is a type of cervical biopsy that is less invasive and removes small tissue areas. They may choose a cold knife cone biopsy if they cannot collect enough tissue through a puncture biopsy. Cold knife cone biopsies allow the doctor to remove more tissue.

A cold knife cone biopsy is a surgical procedure used to remove tissue from the cervix. The cervix is the narrow end of the lower end of the uterus and ends in the vagina. This removes a large conical piece of the cervix to look for precancerous cells or cancerous material. A cold knife cone biopsy is performed under general or regional anesthesia. The surgeon uses a scalpel to remove the cervical tissue.


A method that uses a very cold liquid or a cryoprobe tool to freeze and remove abnormal tissue. Cryoprobe is cooled with liquid nitrogen, liquid nitrogen oxide, or compressed argon gas. Cryotherapy may treat certain types of cancer and some conditions that may become cancer.

Cold therapy can be applied to only one area, or you can choose whole-body cryotherapy. Topical cryotherapy can be done in various ways, including ice packs, ice massages, cooling sprays, ice baths, and even tissue-administered probes.

Laser therapy

Laser surgery is a treatment that may be used to treat cervical cancer. Often performed on women with early-stage cervical cancer, it uses a focused laser beam to generate heat. The laser beam is guided through the vagina and burns abnormal cells from the surface of the cervix. Before the procedure, the patient is given anesthesia to numb the cervix. During this procedure, which is performed on an outpatient basis in a doctor’s office or clinic, patients may experience mild discomfort similar to menstrual cramps.

LEEP (loop electrosurgical excision procedure)

LEEP stands for loop electrosurgical excision procedure. It is a method for testing and treating abnormal cell growth in the surface tissue of the cervix. LEEP is prescribed after confirmation of abnormal changes in the cervix by Pap smear and colposcopy.

During this treatment, a thin wire loop, through which an electric current passes, removes abnormal tissue. Local anesthesia is used to anesthetize the affected area. The doctor usually performs this procedure in the office. It only takes a few minutes, and the patient will be awake during the operation.

How accurate are Pap smear results?

The pop test is very accurate. Regular screening reduces cervical cancer and mortality by at least 80%. This test may be uncomfortable, but minor discomfort can help protect health.

What can be done to reduce the discomfort of the test?

Can anything be done to reduce the discomfort of the test

If a woman is nervous or has a lower pain threshold, there are several things she can do to help reduce any possible discomfort.


Before the test :

  • Ask your doctor about taking painkillers before the test
  • Ask someone to be with you
  • Pee before the test


During the test:

  • Ask the doctor to use the smallest speculum size
  • Ask the doctor to describe what’s happening
  • Practice deep breathing during the exam
  • Try to relax your pelvic muscles


After the test :

  • Use a panty liner or pad
  • Use ibuprofen or a hot water bottle if you experience mild cramps
  • Contact the provider if experiencing heavy bleeding or severe cramping

Regular Pap smears are done to screen for cervical cancer and other possible problems. Although Pap smears are inconvenient for some people, they are a quick process, and there are several ways to make the experience easier.

The bottom line

Arjang Naim MD and his professional team perform the Pap smear test calmly, and if the test results are abnormal, they do the best solution to eliminate the problem early.

Additional questions

  1. What are the five warning signs of cervical cancer?
  • Itching or burning sensations in the vagina
  • Low back or abdominal pain
  • Unexplained fatigue
  • Frequent or urgent urination
  • Abdominal bloating
  1. What is a hysterectomy?

A hysterectomy is a surgical procedure to remove the uterus. A woman can’t get pregnant after the operation.

  1. What is a cervical biopsy?

A cervical biopsy is a procedure to remove tissue from the cervix to test for abnormal or precancerous conditions or cervical cancer.

  1. What should you avoid after a Pap smear?

If you are bleeding, do not have sex and do not use tampons for two to three days after the Pap test. Additional pressure may cause the bleeding to start again or become more severe.

  1. Can low estrogen cause abnormal Pap smear?

After menopause, a woman’s estrogen levels drop to very low levels. Estrogen affects the vaginal tissues. Thinning tissues can cause the cells in the Pap to look abnormal.