Should I Be Worried About An Abnormal Pap Smear?

by Gina M. Florio

For many women, simply hearing the words "pap smear" can ignite a shudder of discomfort. There are definitely more painful things we experience as women, but a pap smear never fails to make us feel uncomfortable, even if only momentarily. For those of us playing catch up, a pap smear, which is also called a "pap test," is a screen for cervical cancer that your gynecologist performs (with your permission, of course) when you go in for an exam. It's a very basic procedure in which your doctor removes some cells from your cervix with a tiny scraper or brush. These cells then get sent off for some testing.

A few things to know about pap smears: If you're between the ages of 21 and 29, you should be opting in for a pap smear once every two years. Any older than that, and you can get it done every three years. A pap test looks for irregular cells in your cervix — it's not a test that will find out whether you have any STI, though, so be sure to ask for a different test if that's what you're looking for.

Finally, it's important to keep in mind that sometimes paps smears come back as abnormal. If your doctor or nurse calls you after your test is over and says your results are abnormal, keep in mind that you're not the first woman to be told so. Up to six percent of people with cervixes get back at least one abnormal pap smear in their lifetime, and most of the time, it's not anything majorly serious.

Of course, it's also not something to be ignored; but just arming yourself with the right information can prevent you from unnecessarily worrying yourself into a frenzy.

Here are five things to know if you find out you have an abnormal pap smear.

1. You Don't Need To Panic And Think The Worst

Seriously, it's not necessary to scare yourself with the C bomb. Sometimes getting back an abnormal pap smear can be attributed to something as simple as an infection or some period or sex-related irritation on your cervix. Then there are times that the test is simply inconclusive because the sample wasn't good enough, so you just have to go back in for round two. The point is, keep your cool until you actually find out what they mean when they say "abnormal."

2. If Your Test Is "Abnormal," That Means The Cells Don't Look Quite Right

If the pap smear truly is abnormal, that means the cells on your cervix have caught the eye of your doctor. They're dividing in a weird way or they're not dying out correctly, and your doc just wants to keep an eye on them to make sure they don't get worse. Keep in mind this doesn't automatically mean you have cancerous or even pre-cancerous cells floating around in your vag. Be sure to sit down (or jump on the phone) with your doctor and go over the results together, so you can get a better idea of exactly how these cervical cells are abnormal.

3. There Are Different Variations Of "Abnormal"

An abnormal pap smear isn't a one size fits all type thing. There are a few different things your cervical cells could be trying to tell you. You might be dealing with a low-grade abnormality, which refers to cell activity that may point to human papillomavirus (HPV) infection. The key word here is may. Getting a low-grade abnormality on your pap smear doesn't even guarantee that you're harboring HPV. It just means you may have it (and that's nothing to worry about, because it's a very common STI) or you simply have to get checked a year later to see if the HPV cells have stuck around. Nothing to really worry about.

There's also the chance that you're looking at a high-grade abnormality. This means you have an HPV infection that's quite persistent, and there's a chance that it could cause you some trouble in the future. It could even lead to cancer later on if it's untreated. But that's why you're getting this pap smear done — to be treated, if necessary. So again, no need to really worry. Another reason not to be wildly concerned: Less than one percent of high-grade abnormalities turn into cervical cancer, according to the National Cervical Screening Program.

Finally, there's a glandular abnormality, which indicates the cells in the inner canal of the cervix are acting strangely. This is much rarer than the first two, but potentially much more serious. In 1996, only 0.2 percent of pap smears had a glandular abnormality, but one in six women who get this result back will have cervical cancer at some point. That latter statistic is concerning, so your doctor will probably have to do a follow-up procedure to find out how to best protect your cervix (which we'll get more into below).

4. The Next Step May Be To Get An HPV Test

HPV is the very thing that leads to cervical cancer, and because these abnormalities point to some kind of association with HPV, your doctor wants to do everything they can to prevent you from being diagnosed with the C bomb. If your pap smear comes back abnormal, it might make logical sense for you to have an HPV test done. Four out of every five people will have HPV at some point in their lives, so it's not anything to fret over. If you have it, then you and your doctor will deal with it. It may increase your risk for cervical cancer in the future (again, key word here is may), but most women with HPV don't get diagnosed at all with cervical cancer.

5. You May Have To Go In For A Colposcopy

Your doctor may ask you to come in for a little something called a colposcopy (not to be confused with a colonoscopy), especially if your pap smear is abnormal and you test positive for HPV. A colposcopy is a microscopic exam of your cervix, vulva, and vagina; a small tissue biopsy is also taken for inspection during a colposcopy. Afterwards, your doctor will get a clearer sense of what's happening down there and whether you need to get any kind of treatment done.

This is all in the name of preventing cervical cancer, so don't take any of these actions to mean you have cancer. Your doctor should walk you through every single step they're taking you through, so if at any point you don't understand what's happening, speak up and ask the hard questions — and make sure you're working with an OBGYN you trust, who lets you ask whatever you please. Every woman and every pap smear is going to be different, so there's no one right answer to anything.

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