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Abnormal Pap Smear

What is a Pap smear?

A Pap smear is a screening test to collect and microscopically examine cells taken from the cervix for the presence of infection, inflammation, abnormal cells, and cancer. A Pap test, along with a pelvic examination, may detect abnormalities that can lead to invasive cancer.

What is an abnormal Pap smear?

An abnormal Pap smear can be caused by cancerous cells. It can also be caused by other cervical and vaginal abnormalities, including dysplasia (precancerous cells) and inflammation.

Inflammation may be caused by:

  • yeast infections
  • trichomoniasis infections
  • bacteria
  • viruses
  • medications or other chemicals
  • hormones
  • pregnancy
  • miscarriage (or abortion)

An abnormal pap smear can be an indication that a patient is infected with human papillomavirus (HPV), which is the most important risk factor for the development of cervical cancer in women over age 30. Cervical cancer is extremely rare in women under the age of 25. Most women younger than 30 can be tested for cervical cancer every other year instead of annually. Women older than 30 can be tested once every three years if they have had three consecutive Pap tests with normal results. Women at high risk for cervical cancer, including those who have a weak immune system or who have been treated for abnormal cervical cells in the past, may need more frequent screenings.

How is an abnormal Pap smear treated?

If the Pap smear shows a significant abnormality, a colposcopy may be performed (using an instrument called a colposcope) to examine the vagina and the cervix. A Schiller test may also be performed, in which the cervix is coated with an iodine solution. The iodine stains healthy cells brown, while abnormal cells maintain their typical white or yellow color. A biopsy may be performed in which the physician removes a small amount of cervical tissue for examination by a pathologist. This is the only sure way to determine whether the abnormal cells indicate cancer.