What is the Connection Between an Abnormal PAP Smear and HPV?

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  • Written By: Matt Brady
  • Edited By: Jenn Walker
  • Last Modified Date: 09 November 2019
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When a woman receives news of an abnormal Papanicolaou (Pap) smear test, it's often an indicator that she has contracted the human papillomavirus (HPV). HPV is the most common sexually transmitted disease (STD). In most cases, the immune system handles the virus, and the infected individual doesn't manifest any symptoms. Certain types of HPV can, however, cause the development of precancerous cells in the cervix, a condition known as cervical dysplasia. If left untreated, dysplasia can develop into cervical cancer. Thus, an abnormal Pap smear and HPV have an important relationship, with Pap smears serving as an important tool for the early detection and treatment of cervical abnormalities.

All women today should get routine Pap smears, about once a year, in order to detect any possible abnormalities caused by infections such as HPV. Prior to the widespread use of Pap smears, far more women suffered and died from cervical cancer. Thanks to the ease with which an abnormal Pap smear and HPV can detect precancerous cells and lesions, far fewer women die of cervical cancer today.


An abnormal Pap smear and HPV don't necessarily mean that a woman has only just recently contracted the virus; HPV can lie dormant in an individual for years before being detected by abnormal test results. As a result, it's often impossible to find out exactly where, how, and from whom HPV was contracted. After laying dormant for a period of time, a strain of HPV might become active for a variety of reasons: a stressful life change or an illness might, for example, trigger HPV symptoms.

The detection of an abnormal Pap smear and HPV is often an indicator of precancer, but not necessarily. HPV can affect cervical cells in a way that doesn't turn out to be cancerous. Other non-cancerous abnormalities caused by HPV include genital warts. To determine whether or not abnormal cells are precancerous, a doctor will often order a colposcopy, a procedure whereby the cervix is investigated with a high-powered microscope. If a doctor then finds reason to believe that cells are precancerous, he or she may order a surgical procedure to remove cervical tissue.

Oftentimes, an abnormal Pap smear and HPV don't require any kind of precancer surgery; in many cases, the body is able to correct abnormal cells on its own. In some cases, however, it may be necessary to remove malignant cervical tissue. If doctors suspect that cells may develop into cancer, they’ll order a surgical procedure, such as a cone biopsy or LEEP procedure, to remove cervical tissue. Whatever tissue is removed is then sent to a lab for further analysis.


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