Receiving your Pap smear results can feel confusing or stressful—especially when medical terms aren’t explained clearly. Understanding your Pap test results is essential for protecting your cervical health and preventing cervical cancer. This complete guide explains what Pap smear results mean, from normal findings to abnormal results and next steps.
What Is a Pap Smear?
A Pap smear (Pap test) is a routine cervical cancer screening used to detect abnormal or precancerous cells on the cervix.
During the test:
- A gynecologist collects cervical cells
- The sample is examined for abnormalities
- Early cell changes are identified before cancer develops
Pap smears have significantly reduced cervical cancer rates and remain one of the most effective preventive screenings available.
Understanding Normal Pap Smear Results
Negative for Intraepithelial Lesion or Malignancy (NILM)
This is the best possible Pap smear result.
It means:
- No abnormal or precancerous cells were found
- Cervical cells appear healthy
- No signs of cervical cancer
What happens next:
- Most women ages 21–65 can wait 3 years before their next Pap test
- Normal results do not necessarily mean you are HPV-negative
- HPV can be present without causing cell changes
Decoding Abnormal Pap Smear Results
An abnormal Pap smear does NOT mean cancer. Most results indicate mild or temporary cell changes.
ASC-US: Atypical Squamous Cells of Undetermined Significance
The most common abnormal Pap result.
What it means:
- Some cervical cells look slightly abnormal
- Cause may include:
- HPV infection
- Hormonal changes
- Inflammation or infection
- HPV infection
Next steps:
- HPV testing is usually recommended
- HPV-negative → return to routine screening
- HPV-positive → colposcopy may be needed
ASC-H: Atypical Squamous Cells, Cannot Exclude HSIL
This result suggests:
- Cells may be high-grade, but confirmation is needed
- Higher risk than ASC-US
Next steps:
- Colposcopy for closer evaluation
- Possible biopsy to rule out precancer
LSIL: Low-Grade Squamous Intraepithelial Lesion
LSIL indicates:
- Mild precancerous changes
- Usually caused by HPV
- Often clears on its own
Management depends on age:
- Under 25: repeat Pap in 1 year
- 25 and older: colposcopy recommended
LSIL rarely progresses to cancer when monitored appropriately.
HSIL: High-Grade Squamous Intraepithelial Lesion
HSIL means:
- Significant precancerous changes
- Higher risk of progression if untreated
Next steps:
- Colposcopy with biopsy
- Treatment options may include:
- LEEP
- Cryotherapy
- Cone biopsy
- LEEP
Follow-up Pap testing is essential after treatment.
AGC: Atypical Glandular Cells
AGC indicates:
- Abnormal glandular cells from the cervix or uterus
- Less common but more concerning
Evaluation may include:
- Colposcopy with endocervical sampling
- Endometrial biopsy (especially if over 35 or abnormal bleeding)
Squamous Cell Carcinoma or Adenocarcinoma
These rare results mean:
- Cancer cells were detected
- Early detection greatly improves outcomes
Next steps:
- Referral to a gynecologic oncologist
- Additional testing and treatment planning
What Is HPV and How Does It Affect Pap Results?
Human papillomavirus (HPV) is the primary cause of cervical cancer.
Key facts:
- High-risk HPV types (16 & 18) cause most cervical cancers
- HPV co-testing improves risk assessment
- Most HPV infections clear naturally within 1–2 years
- Persistent HPV increases cancer risk
Pap + HPV testing together helps guide monitoring and treatment decisions.
What Happens After an Abnormal Pap Smear?
Colposcopy
A colposcopy allows your doctor to:
- Closely examine the cervix
- Highlight abnormal cells using vinegar solution
- Take biopsies if needed
What to expect:
- Office procedure
- 10–20 minutes
- Mild discomfort, possible light spotting
Cervical Biopsy
If needed:
- Small tissue samples are taken
- Results confirm severity of cell changes
- Guides treatment decisions
Treatment Options for Abnormal Cervical Cells
Treatment depends on severity and persistence.
Options may include:
- Observation with repeat Pap testing
- LEEP
- Cryotherapy
- Cone biopsy
- Laser therapy
Most treatments are:
- Outpatient
- Quick recovery
- Highly effective
Factors That Can Affect Pap Smear Results
Certain factors may cause false or unclear results:
- Sexual intercourse within 48 hours
- Douching or vaginal products
- Menstruation
- Vaginal infections or inflammation
Before your Pap test:
- Avoid intercourse 24–48 hours prior
- Do not douche
- Schedule when not menstruating
- Tell your doctor about symptoms or medications
How Often Should You Get a Pap Smear?
Cervical Cancer Screening Guidelines
- Ages 21–29
- Pap test every 3 years
- Pap test every 3 years
- Ages 30–65
- Pap every 3 years OR
- HPV test every 5 years OR
- Pap + HPV every 5 years
- Pap every 3 years OR
- Over 65
- May stop screening if prior results were normal
- May stop screening if prior results were normal
More frequent screening may be needed if you have:
- History of cervical precancer or cancer
- HIV
- Weakened immune system
- DES exposure before birth
Taking Control of Your Cervical Health
You can reduce your cervical cancer risk by:
- Staying up-to-date on Pap smears
- Getting the HPV vaccine if eligible
- Practicing safe sex
- Avoiding smoking
- Maintaining a strong immune system
- Attending all follow-up appointments
Do Not Delay Your Cervical Cancer Screening
Pap smears save lives. Regular screening allows doctors to detect and treat abnormal cells before cancer develops.
If you are due for a Pap test—or have questions about your results—your OB-GYN is your partner in cervical health. Early detection offers the best protection for your reproductive and overall well-being.
Schedule your women’s health appointment with IVANA MD in Missouri City, TX.
Call: 346-585-4077
4220 Cartwright Road, Suite 201
Missouri City, Texas 77459
