While receiving a series of abnormal Pap tests can feel alarming, it doesn’t necessarily indicate cancer. Instead, it typically means that you need further follow-ups to understand what’s causing the abnormal results.
Abnormal results with comprehensive Pap smear tests can occur for various reasons. This guide walks you through everything they might mean, from infections to inflammation. Similarly, we will provide you with information on what you can do to manage them so you can make informed decisions about your health.
What an Abnormal Pap Test Result Means
Abnormal Pap tests generally indicate that the cells in the cervix have changed and are presenting atypically. These changes can range from mild to more concerning, with each type of result signaling a different level of risk and need for monitoring.
Abnormal results are often classified based on the degree and type of cell changes observed, including:
- Atypical squamous cells of undetermined significance (ASC-US). ASC-US is one of the most common abnormal findings. Let’s break it down further below.
“Squamous cells” refer to the types of cells that make up the outer layer of cervical tissue. Meanwhile, from the words “undetermined significance,” we can take it to mean that it refers to minor changes in squamous cells.
Thus, atypical (or irregular) means that there are changes in the cells of your cervix. While these changes are interpreted as abnormal, their clinical importance, however, is not entirely clear. This, while it does not technically count as ‘normal findings’ it may not pose as an immediate cause of concern.
- Low-grade squamous cell intraepithelial lesion (LSIL). LSIL results indicate low-grade changes that are often connected to HPV infection. These changes typically resolve without intervention, though regular follow-up is necessary.
- High-grade squamous intraepithelial lesion (HSIL). HSIL results point to more significant changes in squamous cells, which are more likely to develop into cervical cancer if left untreated. Immediate follow-up is recommended for HSIL findings.
- Atypical glandular cells (AGC). AGC results suggest abnormal changes in the glandular cells, which produce mucus and are higher up in the cervix. This result may require additional monitoring, as it can indicate a higher risk of precancerous conditions.
Regardless of your Pap test results, your OB-GYN will communicate the interpretation findings. If anything about your results still feels unclear, you’re always welcome to ask questions to gain more understanding.
Causes of an Abnormal Pap Test
Now that you know the differences between Pap smear test results, let’s shed some light on what might be causing them. Several factors contribute to cellular changes in your cervix, and each is tackled differently.
Let’s start with some of the most minor and common potential causes.
Minor Possible Causes of Abnormal Pap Tests
Minor causes of abnormal Pap tests do not demand as much urgency in treatment as the more serious ones. However, they might still necessitate follow-up tests and monitoring to ensure they don’t progress further. These include:
1. Inflammation or infection
These specifically pertain to non-HPV infections, such as bacterial vaginosis or yeast infections. Infections caused by these pathogens can result in inflammation and cellular changes that appear abnormal in a Pap test.
In these cases, treating the underlying infection often resolves the abnormal results. However, you must do a few more Pap smear tests so your healthcare provider can confirm that the issue is successfully treated.
2. Hormonal changes
Hormonal fluctuations, especially during perimenopause and menopause, can influence cervical cell health and may lead to abnormal Pap smear results. As estrogen levels decline around menopause, cervical and vaginal tissues become thinner.
This tissue thinning, known as atrophy, can make cervical cells appear irregular or atypical when examined and interpreted as ASC-US. This hormonal effect is not a critical issue, but it does highlight how hormonal changes can impact cervical health. Thus, you’ll need to work closely with your OB-GYN to monitor the progression of changes as your hormone levels continue to shift.
For some women, these hormonal changes may also affect vaginal pH and natural lubrication, which can contribute to inflammation or irritation in the cervical area. This irritation, often coupled with dryness, can lead to changes in the appearance of cells that may prompt further examination.
READ ALSO: Understanding the Signs and Symptoms of Menopause
3. Lifestyle factors and immunity
Lifestyle choices, mainly smoking and a weakened immune system, can significantly influence the results of a Pap smear test.
Smoking, for instance, has been linked to cellular changes in the cervix, as the chemicals in tobacco can harm cervical cells and make them more susceptible to infections such as HPV. The carcinogens in cigarette smoke can directly damage DNA in cervical cells, increasing the likelihood of abnormal cell growth and raising the risk of an abnormal Pap result.
Additionally, smoking has been shown to reduce the effectiveness of the immune system, making it harder for the body to clear HPV infections naturally, thereby prolonging the disease and the associated risk of abnormal cell changes.
A compromised immune system—whether from stress, chronic illness, or conditions like HIV—also makes it harder for the body to fight off infections like HPV. When the immune system is weakened, abnormal or precancerous cells are more likely to persist and grow, making regular monitoring through Pap smears especially crucial.
4. HPV and why regular Pap smear tests are crucial
HPV, or human papillomavirus, is a common sexually transmitted infection. While many of these infections are harmless and resolve independently, some high-risk strains can lead to abnormal cell changes on the cervix.
When you get a Pap smear to check for HPV, healthcare providers will check for any abnormal cell changes that may indicate cellular changes related to it. If high-risk HPV is detected, your doctor will recommend more careful follow-up tests to ensure that any abnormal cells are identified and managed while they are easy to treat.
Left untreated, these high-risk HPV strains can cause abnormal cell growth to progress, potentially leading to precancerous or cancerous lesions. Regular Pap smears are essential in spotting these changes early, allowing for intervention while the abnormal cells are still manageable.
Follow-Up Procedures for Abnormal Pap Tests
The next steps after an abnormal Pap result depend on the type of abnormality and the associated level of risk. Each follow-up procedure provides additional insight into the cervical cells’ health and determines whether further treatment is needed.
- HPV testing. HPV testing is a common follow-up procedure used to check for high-risk HPV strains. In many cases, an HPV test is performed alongside a repeat Pap test to help determine if the abnormal cells are likely to resolve or require further monitoring.
- Colposcopy. Colposcopy is a closer examination of the cervix using a magnifying instrument. During this procedure, a healthcare provider may apply a solution to highlight any abnormal areas and may take a biopsy of any suspicious tissue. It helps get a more detailed look at the cervical cells and determine the extent of any cellular changes.
- Endocervical curettage (ECC). ECC involves sampling cells from the endocervical canal, which connects the cervix to the uterus. This test can be beneficial when AGC or HSIL results require further investigation.
- Biopsies. A biopsy is a small sample of tissue taken from an area with abnormal cells for closer examination. In cases of HSIL or AGC, a biopsy can provide a clearer understanding of the degree of abnormality and help guide appropriate treatment options.
Management and Treatment Options for Abnormal Pap Tests
Proactive treatment can prevent abnormal cells from progressing, particularly when results indicate a higher risk of developing cervical cancer. You can explore various options with your OB-GYN depending on the type of cell changes revealed.
- Regular and vigilant monitoring of changes. Regular follow-up Pap tests are often sufficient for minor abnormalities such as ASC-US or LSIL. Many low-grade changes resolve naturally without intervention. Vigilant observation allows your healthcare provider to manage any ongoing changes properly.
- Loop electrosurgical excision procedure (LEEP). LEEP removes abnormal tissue using a thin wire loop that carries an electrical current. This procedure can be performed in-office and is an effective treatment option for more significant cell changes, such as HSIL.
- Conization or cone biopsy. For more advanced cases, a cone biopsy removes a cone-shaped section of tissue containing abnormal cells. This procedure allows for a deeper examination and is usually recommended when more extensive cellular changes occur.
Pap Smear Tests: A Pillar to Safeguarding Women’s Health
Although monitoring them is critical to timely intervention, cellular changes in the cervix can be easily neglected without an established routine for Pap smear tests.
Above all, the information we learned today reminds us that Pap smear tests are essential in preserving reproductive health. While abnormal test results won’t always point to something serious, proactiveness in your health allows for more comprehensive preventive care and effective treatment.
If anything about your abnormal Pap smear test results needs clarification or if you’d like a retest, you’re always welcome to discuss it with your OB-GYN. Our Atlanta Obstetrics & Gynecology Specialists team is ready to provide compassionate guidance.
Schedule your appointment today and confidently tackle your health concerns alongside our experts.