Abnormal Pap Results: What to Expect at Your Follow-Up Colposcopy

One of the best screenings for cervical cancer is the Pap test, also known as the Pap smear. While it doesn’t top any woman’s list of desirable experiences, it’s a useful tool for detecting cervical cancer. 

The Pap test is a simple precaution that usually comes back “normal.” For the few who receive abnormal results, the news can be distressing, but not if you know the truth: The medical director of the Women’s Health Center, Johns Hopkins Outpatient Center and co-director of the Johns Hopkins Colposcopy Clinic states that “Most women [with abnormal Pap results] do not have cancer.”

And we agree. 

Board-certified OB/GYN Dr. Anju Nayar and our Nova Women’s Health team in North Reading, Massachusetts, know that abnormal Pap smears are nothing to panic about, but they do require a follow-up to ensure all is well. That’s what a colposcopy does. Here’s what you should know.

What does an abnormal Pap smear mean?

Every three years, between the ages of 21 and 29, a Pap smear is a routine part of your well-woman exam at Nova Women’s Health. When you turn 30, we add the human papillomavirus (HPV) test to your Pap smear because HPV causes most cases of cervical cancer. 

During a quick, painless Pap test, we swab your cervix to grab a sample of the cells and send it to the lab to look for abnormal cells and cells that have changed since the last time we checked. The results return as:

• Normal or negative: Everything is OK
• Unsatisfactory: There weren’t enough cells for the lab to analyze, or they were clumped together
• Abnormal or positive: You have a few cells that don’t look like the others

Only 3.8% of Pap smear results are abnormal, but most don’t indicate cancer. In fact, most abnormal cells simply indicate a vaginal infection. The Pap smear is just the first in a series of tests and tools we use to ensure your health. The next step is a colposcopy to rule out cancer.

Colposcopy: Why you need it and what it detects

An abnormal Pap smear is the primary reason for a colposcopy, but Dr. Nayar may also recommend one if:

• She noticed abnormal cervical structure during a routine pelvic exam
• You tested positive for HPV
• You have unexplained vaginal bleeding

A colposcopy feels a lot like a Pap smear. Dr. Nayar inserts a speculum into your vagina to hold it open, allowing her to visualize the inner tissues. She applies a special staining solution that causes abnormal cells to stand out under a bright light and magnifying lens. 

If she detects abnormal cells, she may opt to perform a cervical biopsy, where she takes a tiny tissue sample from your cervix. You’ll feel a quick “pinch” and may experience cramping and light bleeding for the next few hours and up to a few days. Call us right away if you experience:

• Heavy vaginal bleeding (especially if it lasts more than a week)
• Foul-smelling vaginal discharge
• Cramps or pelvic pain that don’t subside
• Fever

We send the tissue sample to the lab and await the results, which take a week or two. If the results show precancerous or cancerous cells, Dr. Nayar discusses your treatment options. Often, we can remove the suspicious cells in the office using cryotherapy, a cone biopsy, or a loop electrosurgical excision procedure (LEEP). 

However, more often than not, the results are negative, and Dr. Nayar puts you on a regular schedule of Pap smears and colposcopies to monitor your cervical cells. 

Don’t let an abnormal Pap smear scare you. Talk to Dr. Nayar about your test results, a colposcopy, and your many treatment options. Book an appointment online or call Nova Women’s Health today.