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What Is an Abnormal Pap Smear?

A Doctor Explains What an Abnormal Pap Smear Is and What Can Be Done About It

Photographer: Paul KabataRestrictions: For editorial and internal use only. No advertising or print.Product Credits: Tibi Top,Rodebjer Jeans

When it comes to preventative exams, they can seem minuscule and unimportant, but they're a great opportunity to discuss topics like your period, reproductive health, and other preventative measures with your doctor. A pap smear is a common exam that screens for cervical cancer, and the results, especially when they're deemed abnormal, can come with a lot of confusion and questions.

To help you understand what an abnormal pap smear is and how you can prevent cervical cancer, POPSUGAR spoke with Alyssa Dweck, MD, a gynecologist in New York and author of The Complete A to Z For Your V: A Woman's Guide to Everything You Ever Wanted to Know About Your Vagina. She first stressed that an annual preventive exam and a pap smear are two different things. While an annual preventive exam is great for your overall health, the purpose of getting a pap smear is to screen for cervix cancer (the opening of the uterus) and to "catch it so early that it never progresses to cancer," Dr. Dweck explained. Although the guidelines for a pap smear are less frequent (women ages 21 to 65 should get screened every three years) than annual preventive exams, they're still recommended.

Finding out that your pap smear results have come back abnormal can be daunting, but Dr. Dweck says to remain calm because a pap smear is just a screening test. The ranges of abnormalities come in stages, with the first being a normal pap smear. Second, you can have a pap smear that shows mildly atypical cells, "and usually that's nothing to worry about," according to Dr. Dweck. A low-grade abnormality is also possible, where the cells look precancerous but they're mild. From there, Dr. Dweck explained that you can have precancerous cells that are worse than mild, becoming "moderate to severely abnormal, but still precancerous." Finally, your test can show signs of cervical cancer, which could be from an early stage or advanced stage of cancer.

For women 30 and older, Dr. Dweck says an HPV test will be done (this is also contingent upon someone's age and risk) along with a pap smear as a "duo-layer screen for cervix cancer." If your results are abnormal, your doctor will suggest having a colposcopy, where your cervix is looked at with a microscope. Dr. Dweck says that during a colposcopy, the doctor will take very small biopsies (tissue samples of the cervix) "to see if there's really an abnormality or if a pap smear called it wrong." Dr. Dweck told POPSUGAR that a colposcopy is more accurate than a pap smear and is considered the confirmatory test. "The next natural progression is that a good portion of those things will get better by themselves," added Dr. Dweck. If abnormalities are significant, Dr. Dweck explained that the next step to take would be to get a loop electrosurgical excision procedure (LEEP) to remove areas of the cervix where the abnormal cells exist.

There are vaccines that can prevent many strains of HPV, and Dr. Dweck shared that "in the medical field, we consider this to be an anticancer vaccine because HPV can cause cervical cancer, oral cancer, anal cancer, and penis cancer — so we're trying to push the vaccine for anticancer reasons." Dr. Dweck encourages people to strengthen their immune response, get enough sleep, keep stress low, have a good diet, and not to smoke.

Image Source: POPSUGAR Photography / Paul Kabata
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