What if my pap smear is abnormal?

If you’re over age 21 and have had a well-woman exam, you’ve probably had a pap smear. It’s a quick test, and can be briefly uncomfortable, but what does it check for and how often should you get one?

Jade Elliott spoke with Martie Nightingale, a certified nurse-midwife with Intermountain Healthcare, to answer your questions about pap smears, why they’re important and what it means if your test comes back abnormal.

What is a pap smear and what does it check for?

A pap smear is a test that detects precancerous changes on the cervix. The cervix is the lowest part of the uterus, located inside the vagina. A virus called the human papillomavirus or HPV, often causes cervical cancer. HPV can be passed during sexual contact.

A pap smear requires your provider to place a speculum into the vagina to view the cervix, then scrape away cells from the cervix using a brush. Once removed, the cells are tested for abnormal changes.

Why is it important to get a pap smear?

Getting regular pap smears allows these precancerous changes to be detected and treated before it turns into cervical cancer.

Women with early cervical cancers usually have no symptoms.

Symptoms of cervical cancer often do not begin until the cancer is growing quickly and begins to spread to other body parts. When this happens, the most common symptoms are:

Abnormal vaginal bleeding
Unusual vaginal discharge
Pain during intercourse

What to know before your appointment?

Schedule your pap smear for a day when you are not having heavy period bleeding. If you must go during your period, avoid putting anything in your vagina for at least 24 hours before your appointment.
Avoid douching.
Abstain from sexual intercourse for one to two days before your Pap smear.

At what age should you get your first pap smear? How often should you get a pap smear?

Current recommendations for cervical cancer screening include pap testing every three years beginning at age 21, and beginning at age 30 a pap test with HPV testing (co-testing), every five years, or pap testing alone every three years. Women with HIV or a weakened immune system may require more frequent or additional testing.

What does it mean if your pap smear comes back abnormal?

Most abnormal test results don’t mean you have cancer. An abnormal pap can result from temporary changes like a vaginal infection, or reactive or repairing cells that may need to be monitored a bit more frequently.

What would be the next steps if it’s abnormal?

Recommended next steps depend on your age, type and severity of abnormality, and previous history, and may include additional testing for high-risk HPV, repeat testing in one year, or a colposcopy exam with cervical biopsy.

Where can women go for more information?

American College of Obstetricians & Gynecologists (ACOG) is a great resource for patient information.

Cervical Cancer Screening

Abnormal Pap Test results

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.