Abnormal Pap Smear - What It Means and What To Do?

There are false positives and false negatives on Pap smears. After your doctor takes that huge Q-tip and swabs your cervix, the cells on the Q-tip are rubbed off onto a piece of glass called a "slide." Then a thin plastic piece is put on top to keep it all together. The tests are looked at by people who have been trained to look at them, but sometimes they miss something because they don't look at the entire slide. Other times they aren't quite sure what they see, so they flag it as possibly abnormal.

You may hear that your Pap showed "ASCUS," which means atypical squamous cells of undetermined significance. In other words, they saw something that wasn't completely normal, but not totally abnormal either so they just don't know for sure.

A lot of doctors will have you come back in a few months for another Pap smear to see if it changed to normal, or if there was inflammation, they may treat you with antibiotics to clear up the cervical infection.

If the Pap also showed positive for HPV, however, then ASCUS means a little bit more. Since HPV is the primary cause of cervical cancer, being positive for HPV with an ASCUS Pap result will usually make your doctor want to do some more testing.

Your doctor will probably want to do a colposcopy with a biopsy in the office. The colposcopy simply means looking at your cervix with a special microscope called a colposcope. The biopsy is done with a metal tool that literally pinches off a piece of tissue from your cervix. Yes, I think it hurts, but it is very quick, so they don't use anything to numb it up first.

That biopsy is also sent off to a pathologist who looks at it for abnormal changes. If there is mild dysplasia, they probably won't do anything yet, but have you come back in a few months and check again.

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