What it means when you get an abnormal Pap smear result

For some women just the thought of going to get a Pap smear is terrifying. So you can imagine the feeling when I, at the age of twenty-one and from my second Pap smear ever, was told that my results were abnormal.

My doctor told me that it wasn’t cancer and not to worry, but this was offering me no relief or comfort. If it wasn’t cancer then what was it? What did abnormal mean? She kept using all these terms and phrases that I had no idea about and it was the thought of the unknown that was the most terrifying. 

Before it happened to me I had no idea that you could have results from a Pap smear that weren’t either perfectly normal or cervical cancer. Nobody tells you about the stuff that’s in between and after my own experience I think it’s important for all women to know every outcome and why having regular Pap tests is so important. If I hadn’t had a Pap smear, I might have ended up with cervical cancer. It was because of regular testing that they could treat it before it got to that stage. 

What does an abnormal result mean? 

The Australian Cervical Council Foundation (ACCF) website explains that there are two categories of abnormalities that can show up on a Pap smear result.

The first is inflammation, which is often caused by an irritation from a bacterial infection or thrush. Further treatment is usually unnecessary.  

The second is low-grade or high-grade abnormality (also known as CIN 1 AND CIN 2). I had both. Some of my cells showed low-grade abnormalities whilst some showed high grade.

If either abnormality is indicated from your Pap smear it means that you have an infection called Human Papilloma Virus (HPV). According to the National Cervical Screening Program ‘Anyone who has ever had sex can have HPV- it’s so common that four out of five people will have had HPV at some time in their lives. In most cases, it clears up by itself in one to two years. In rare cases, if left undetected, it can lead to cervical cancer – this usually takes about 10 years.’

Hiranthi Perera, Program Manager at PapScreen Victoria says that ‘High-grade abnormalities are more serious and more likely to develop into cervical cancer if left untreated. It is impossible to tell which high-grade changes will develop into cervical cancer and which will not. This is why it’s important to get any high-grade changes treated if your doctor advises it. Even for high-grade abnormalities, treatment is usually simple and effective if detected early.’

What is a Colposcopy?

Because my pap smear showed high-grade abnormalities, the next step was to have a colposcopy. A colposcopy is when a specialist examines your cervix using a magnifying instrument called a colposcope.  I was also told that because of my Pap smear results, a biopsy would most likely be taken at the same time. 

The experience is quite similar to having a regular Pap smear, except it takes about ten minutes longer. The National Cervical Screening Program explains that ‘If the colposcopy shows only a low-grade abnormality, you will not usually require a biopsy.’ My colposcopy showed high-grade as well as low-grade abnormalities, so I was required to have a biopsy. Some women experience a sharp pinch when the biopsy is taken but I can honestly say that I didn’t feel any pain. Once the colposcopy is over, it takes around 7-10 days for the results.

Further treatment

After my colposcopy results, I had a wire loop excision (also known as LEEP or LLETZ) to remove the abnormal cells. The procedure was completed in the clinic’s day surgery and I was put under general anesthetic. I was able to go home the same day and returned to work two days later. Other procedures to remove abnormal cells can be a cone biopsy, laser treatment or diathermy. It will depend on the type of abnormality and what your doctor thinks as to which treatment will be best for you. 

What if I’ve had the cervical cancer vaccine? 

I was at school when the cervical cancer vaccine was introduced. I had all three needles and never thought I would have an abnormal pap smear. But I did. I am the perfect example as to why you still need to have regular pap smears even if you’ve had the vaccine. 

Hiranthi Perera, Program Manager at Papsmear Victoria says, “Cervical cancer is one of the most preventable cancers - having a Pap test every two years will reduce your risk of developing the disease by around 90 per cent. Pap tests check for abnormal cell changes before they become cancerous, when treatment is usually straightforward and effective.”

It’s important to know that while the vaccine does protect you from some forms of HPV, it doesn’t make you immune. Perera says “There are many strains of HPV that can cause cervical cancer. The vaccine protects against two strains of HPV (16 and 18) that cause around 70 per cent of cervical cancers.” By having regular Pap smears you are protecting yourself from the remaining 30 per cent, which could potentially turn into cervical cancer. If abnormal cells are detected early, there is a high chance they can be removed before turning into cancer and that is definitely worth a few minutes of awkwardness every two years.

Have you ever had an abnormal pap smear? Did you know it was possible to have abnormal results that weren’t cervical cancer?