After an abnormal Pap screening, what comes next?

Outside yearly exam

Many women leave their annual gynecologist appointment without giving their Pap smear a second thought. But if you're part of the small percentage of women who receives the news that her results were abnormal, your Pap smear may be all you can think about.

While it's true that Pap smears are used to detect cervical cancer in its earliest stages, don't jump to conclusions.

"An abnormal Pap smear doesn't necessarily mean cancer. Abnormal results can be indicative of a variety of different cell changes, including infections, noncancerous strands of human papillomavirus (HPV) or menopause, none of which are typically cause for concern," explains Alicia Shields, DO, FACOG, OB/GYN with Main Line HealthCare OB/GYN in Blue Bell.

While the probability of cervical cancer being the cause of your abnormal Pap smear results is low, what happens if you do receive abnormal results?

"Depending on your risk, your gynecologist will likely recommend one of two options: wait one year and follow up with another Pap smear and HPV testing, or schedule a diagnostic test called a colposcopy for further examination," says Dr. Shields.

If your screening results fall into the category of ASC-US, a classification determines cells are abnormal but of undetermined significance, and you are under the age of 24, your gynecologist may advise waiting until your next Pap smear to make any additional treatment decisions.

However, if your screening results indicate a more serious risk, your gynecologist may recommend a colposcopy to better diagnose any abnormalities.

A colposcopy: What to expect

Perhaps the most common way to address cervical changes, a colposcopy is a diagnostic test that allows for further examination of the reason behind your abnormal results.

During a colposcopy, your gynecologist will use an instrument that will magnify the cervix and look for any irregularities. If something appears irregular, a small sample of tissue will be taken for biopsy. Your biopsy results can help determine whether or not you need further treatment.

"If your colposcopy results are negative, your gynecologist will likely just ask that you make an appointment for another Pap smear in a year. If your results are positive, however, this means that these cells have the potential to become cancerous and may need to be removed," explains Dr. Shields.

Your gynecologist can help you determine what treatment option is best for you, and discuss your recommended cancer screening options going forward.

Although getting called back for abnormal screening results is rare, don't let the fear of a phone call keep you from taking steps to protect your health.

"A Pap smear is one of the best ways to protect yourself from cervical cancer, and to detect any abnormalities early. For this reason, it's important to make and keep your annual appointments and talk to your health care provider about any concerning symptoms," says Dr. Shields.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654).

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