What to Expect After an Abnormal Pap Smear

Nobody likes the sound of any medical test returning “abnormal”, and furthermore, nobody likes the x sound in Uman papilloma (HPV). When I heard these two words in one sentence, I was, as expected, completely shocked.

Human papillomavirus can cause cervical cancer, but it takes years. Meanwhile, a Pap smear can detect cells that begin to grow abnormally, even if they are not already cancerous.

This can happen even if you have been vaccinated against HPV. The vaccine only protects against a few types of virus (the newest, Gardasil 9, can protect against nine ), but there are over 100 viruses that can affect your body . I got the vaccine but got abnormal smears on more than one occasion. (The first time this was five years ago . More recently, I was told that my cells are high-level damage, which means that my cells are anxious and rapidly changing.)

The virus can stay dormant in your body for up to sixteen years before any abnormal cells or symptoms show up. What’s more, according to Clinical Advisor , HPV can “persist and recur.”

When Pap smears show abnormalities, it is due to the presence of the virus in cells in the cervix called squamous cells. Your screening for cervical cancer may include a Pap test, an HPV test, or both. There may be other causes of abnormal results – such as a bacterial or yeast infection but HPV is the most common.

What results are abnormal?

Low-grade squamous cell lesions : These are small abnormal cellular changes in the cervix. In most cases, your body can fight this HPV infection on its own.

High-grade squamous cell lesions: These are more serious and serious cellular changes in the cervix that, if left untreated, can lead to cancer.

Squamous cell carcinoma : This is cancer of the cervix that is found deep in the cervix and other organs or tissues. Most doctors do not detect cervical cancer with a Pap test alone.

If any of these changes are found after a Pap test, a biopsy (colposcopy) may be done , usually at a separate visit to your doctor. Like a Pap test, a colposcopy is when your doctor asks you to sit on the stirrups to get a better view of the cells under the colposcope . Your doctor will apply a solution similar to vinegar to the cervical area to highlight the problem area. If your doctor notices any visible changes, he will take a tissue sample and send it to the laboratory for further testing. While the tissue is gathering, you may feel mild cramps, similar to menstrual cramps; sometimes the spasms can be more intense, like with an IUD inserted. If the test fails, or if more abnormal cells are found in the laboratory, another procedure will be required.

According to women’s health experts , 90% of low-grade and 70% of high-grade cells will become normal when the body’s immune system fights the HPV virus or “clears it out.” In most people, your cells will return to normal. Others require further testing and procedures.

“The vast majority of women heal [infection] in 20 months [without medication],” Nicole S. Nevadunsky, MD, told SELF magazine. However, dangerous strains do exist and do lead to cervical cancer. What happens to people who do not heal, whose bodies do not heal the infection?

Your options

If the results show that the cells are ineffective, your doctor will recommend that you have another Pap test after a year. If you have high quality cells, you will be asked to undergo a preventative procedure to remove the abnormal cells so that they cannot develop into cervical cancer in the future.

Treatment includes:

  • LEEP (Electrosurgical Loop Removal Procedure), which is a wire loop that carries current to remove tissue from the cervix.
  • Cryotherapy, in which pathological tissue is removed by freezing it.
  • Laser therapy, in which a narrow beam of light destroys or removes abnormal cells.
  • Conization, which uses a knife, laser, or electric current to remove a tapered piece of tissue.

Does an abnormal Pap smear mean cancer?

The good news is a resounding “no” – abnormalities do not immediately indicate cervical cancer. However, we do know that almost all cervical cancer is associated with two types of HPV, 16 and 18. These two types cause 70 percent of roughly all cervical cancers , according to the National Cancer Institute.

Cervical cancer takes years to form as it is a slow-growing cancer . According to current CDC guidelines , people between the ages of 21 and 29 should be screened every three years, and those between the ages of 30 and 65 every five years. Once they find abnormal cells, they will ask you to come back every six months or a year.

While I want to emphasize that an abnormal pope definitely does not mean a death sentence, he should be taken seriously. As STIs are at an all-time high , we must discuss safer sex options and encourage regular Pap tests.

What is LEEP

My high-grade cells meant an increased risk of squamous cell carcinoma of the cervix. I returned for two biopsies after my first Pap test results reported abnormal cells. After the second result, I was asked to go through a removal procedure called LEEP .

LEEP is performed in the gynecologist’s office. The doctor first applies pain relievers to relieve discomfort. The electric wire cauterizes the tissue, and the removed cells are checked for precancerous or cancerous results. The procedure is a bit like having an IUD inserted – you will feel cramping and discomfort and are likely to be a little nervous. The procedure takes about ten minutes, after which light bleeding should follow. To prevent infection, nothing should get into the vagina – including intercourse and tampons – for six weeks.

After LEEP, your doctor may ask you to come back four or six months later for a follow-up Pap test.

Approximately 12,900 women are diagnosed with cervical cancer annually and 4,400 die. Although HPV is common enough that SELF magazine named it “NBD” in a 2016 article, procedures like LEEP carry a small risk of complications such as excessive bleeding. But if high-risk HPV cells are not detected or ignored, the risk of cervical cancer increases – which is why careful screening is so important. Taking control of your health, quitting smoking , using condoms during intercourse, and getting anHPV vaccine will significantly lower your chances of getting the virus and lead to a safer future for you and your cervix.


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