What is an Abnormal Pap Smear?

An abnormal pap smear is a pap smear which has shown irregularities when viewed under a microscope by a laboratory technician. Abnormal pap smears are not uncommon, and many women experience at least one abnormal result over the course of their lives. There are a number of causes for an abnormal pap smear, and while the result should be addressed, it should not be viewed as a cause for immediate panic.

Although the pap smear is used primarily as a screening test to pick up early signs of cervical cancer, an abnormal pap result does not necessarily mean that a woman has cancer. A number of things can cause changes in the cells of the cervix, ranging from inflammation to infection with a sexually transmitted infection. It's important to follow up on an abnormal pap smear to find out why the result was abnormal before deciding on the next step.

In addition to revealing signs of cervical cancer, pap smears can also be abnormal as a result of yeast infections, irritation, inflammation, human papilloma virus (HPV) infection, or infection with other sexually transmitted infections. If a laboratory returns abnormal results to your doctor, he or she will usually recommend a follow-up examination to discuss the results. After interviewing you, the doctor may decide to take another pap smear, run a test for sexually transmitted infections, or prescribe a medication to treat an yeast infection or inflammation. If he or she is especially concerned, a colposcopy may be recommended. In a colposcopy, the doctor examines the cervix, vagina, and labia with a high-powered microscope to identify areas of irregularity and take samples for biopsy.

Usually, a laboratory doesn't just say that a pap smear was “abnormal,” it describes the type of abnormality observed. Many labs rate abnormal results from one to five, with ones being the least serious, and fives being an issue for concern. An abnormal pap smear may also turn up things like atypical squamous or glandular cells, or low and high grade squamous intraepithelial lesions. These terms all describe specific types of cell changes which may be observed.

Sometimes, a lab returns a pap smear as “unsatisfactory” or “inconclusive.” This isn't meant to cast aspersions on the patient. Rather, it indicates that the sample taken during the pap test was not good enough to be examined conclusively under a microscope, which means that another sample needs to be taken. Sometimes an abnormal pap smear is also a false positive result because the sample became contaminated or looked slightly “off” under the microscope, but nothing is wrong.

If a woman has several abnormal pap results in a row, it can be a sign that she is developing cervical cancer, and more aggressive diagnosis and treatment may be required.