Cervical Cancer

Abnormal results and next steps

First and foremost, it’s completely natural to be worried and even a little scared about an abnormal result. An abnormal Pap test result means the cells taken from your cervix look different than normal cells when seen under a microscope. What’s important to keep in mind is that cell changes found through Pap tests are very rarely cancer. As well, when these changes are caught early, they can be watched closely and treated so that cancer doesn’t develop.

What causes an abnormal result?

What happens after an abnormal result?

What is HPV reflex testing?

What is a colposcopy?

After a colposcopy

What causes an abnormal result?

Sometimes infections caused by bacteria or yeast can cause cells to look abnormal under a microscope. However, most often, abnormal Pap test results are caused by HPV.

What happens after an abnormal result?

No doubt, hearing that you have abnormal cervical cancer screening test results can be upsetting. But the most important thing you can do for yourself is go for follow-up appointments to find out if the cells have returned to normal or if they need to be treated so cancer doesn’t develop.

The next steps really depend on the type of abnormal results you have.

  • If you have low-grade (minor) cervical cell changes and your Pap test sample was not tested for high-risk HPV, your healthcare provider will repeat your Pap test in 6 to 12 months. Minor cell changes often go away on their own, and if your cells return to normal you won’t need treatment.

  • If you’re 30 years or older and the lab sees cell changes that are hard to read, your Pap test sample will be tested for high-risk HPV (HPV reflex testing). If HPV is found, your healthcare provider will refer you for a colposcopy. If HPV is not found, you won’t need any further tests until your next regular Pap test.

  • If you have low-grade (minor) cervical cell changes that don’t go away, OR if you have high-grade (moderate/severe) changes, your healthcare provider will likely refer you to a specialist (gynecologist) for a colposcopy to examine your cervix more closely.

cervicalcells

What is HPV reflex testing?

If you’re 30 years or older and the lab sees cell changes in your Pap test that are hard to interpret, your Pap test sample will be tested for HPV. This is called HPV reflex testing. When women in this age group have high-risk HPV, their infections are more likely to be longer lasting. And longer lasting infections are what cause serious cell changes. Your healthcare provider will want the cells of the cervix looked at more closely.

If your HPV result shows that you don’t have HPV, you won’t need any further tests until your next regular Pap test. Your risk of developing cervical cancer over the next few years is about the same as women who have a normal Pap test result. If you do have HPV, it means the changes seen in your cervical cells were most likely caused by a high-risk HPV type. Your healthcare provider will refer you for a colposcopy. It is important to remember that having HPV doesn’t necessarily mean that you or your partner was unfaithful. The virus can hide in your body for years without any sign that it’s there. You or your partner may have been infected long before you became a couple.

What is a colposcopy?

A colposcopy is an exam that’s similar to a Pap test in some ways, but is done by a doctor that specializes in women’s reproductive health (a gynecologist).

The specialist will:

  • Insert a speculum into your vagina, and then put a mild vinegar solution on your cervix that will cause areas of abnormal cells to turn white.

  • Use a colposcope (a high-powered microscope) to look closely at any abnormal areas of your cervix.

You shouldn’t feel any extra discomfort during this procedure because the colposcope stays outside your vagina.

After a colposcopy

If an abnormal area is seen during the colposcopy, your specialist may decide to take a biopsy, or a tiny sample of cells, from the abnormal area.

There’s a chance you’ll feel some pinching or cramping, but the discomfort should go away quickly.

The biopsy sample will then be sent to a lab and examined under a microscope to help determine whether you need treatment.

If the colposcopist determines that you have:

  • low-grade cell changes, you’ll be followed closely to make sure the cells return to normal. You may have to have a repeat Pap test in several months or another colposcopy.

  • high-grade cell changes, treatment will be recommended so that cancer doesn’t develop.
     

When the abnormal changes have gone away on their own or have been treated, you will need to see your own healthcare provider for regular Pap testing:

  • if you had low-grade cell changes, you’ll need to have a Pap test every year for 3 years. If all 3 results are normal, you likely can start having Pap tests every 3 years.

  • If you had high-grade cell changes, your healthcare provider will likely advise you to keep having a Pap test every year to help ensure cervical cancer doesn’t develop.

The following is a detailed video taking you through what it means to get abnormal results. Although the video discusses having Pap tests every 2 years, Alberta guidelines recommend having a Pap test every 3 years for most women. From HPVInfoCanada.

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