After an Abnormal Pap Smear, Here’s What Happens Next

Have you just learned that you had an abnormal Pap smear? It’s important to understand that this finding doesn’t automatically mean you have cancer. In fact, it's quite rare for an abnormal Pap smear to indicate the presence of full-blown cervical cancer.

At the OB/GYN practice of Daniel S. Kushner, MD, we provide the highest standard of care in Queens and White Plains, New York. With over 20 years of experience, Dr. Kushner is an expert in reproductive health, and our patients praise his empathy and compassion in diagnosis and treatment of gynecological conditions. 

When it comes to abnormal Pap smears, that expert care all starts with understanding your results.

Your Pap smear result

Pap test findings are classified as either normal, abnormal, or unsatisfactory. An abnormal result means that some cervical cells look different than expected.

These changes could be minor and go away on their own, or they might need closer monitoring or treatment. There are different types of abnormal findings:

• Atypical squamous cells (ASC)
• Low-grade or high-grade squamous intraepithelial lesions (LSIL or HSIL)
• Atypical glandular cells (AGC)
• Adenocarcinoma in situ (AIS) 
• Cervical cancer
• Signs of human papillomavirus (HPV) infection

An unsatisfactory result means that the cell sample didn't have enough cells or the cells were obscured by blood or other fluids. With an unsatisfactory result, you need another Pap test within several months to get clearer results.

What happens after an abnormal Pap smear

Your next steps depend on your age, the type of cell changes found, and whether HPV was detected — some studies show that it accounts for about 7 in 10 abnormal Pap smears. Dr. Kushner takes the time to explain what your results mean and supports you in taking the next steps.

He may recommend one of the following:

Repeat Pap test

Retesting usually occurs within 6-12 months. In some cases, Dr. Kushner may request another Pap test immediately.

HPV testing

Dr. Kushner may recommend separate HPV-specific testing to check for high-risk strains of the virus. Some patients may have co-testing — Pap and HPV tests at the same time — although the American College of Obstetricians and Gynecologists (ACOG) recommends this only for women over 30.

Colposcopy

A colposcopy is a test in which Dr. Kushner uses a high-powered microscope (colposcope) to get a closer look at your cervix. The scope doesn’t go inside your body — it just helps the doctor see better. For this test, Dr. Kushner swabs a vinegar solution on your cervix. This solution helps highlight any abnormal areas.

The test might feel slightly uncomfortable, similar to a Pap smear, but it usually doesn’t hurt.

Sometimes, Dr. Kushner may do a biopsy, taking a tiny tissue sample to test. The sample goes to a lab, where experts study it intensively to determine whether the cells are precancerous (cervical dysplasia), cancerous, or neither. Biopsy results take around two weeks, at which time you'll discuss the outcome with Dr. Kushner and determine the next steps.

After cervical cancer testing: The next steps

What happens next depends upon your test results. In some cases, Dr. Kushner recommends a watchful waiting approach, continuing with regular Pap smears. 

If you have precancerous cells, Dr. Kushner typically recommends treatment to remove them and prevent them from turning into cancer. Common options are loop electrosurgical excision procedure (LEEP), cryosurgery, laser therapy, and colonization (cone biopsy).

In the rare event that your results show cervical cancer, you have options. Dr. Kushner can explain all the treatment approaches, from radiation to chemotherapy, immunotherapy, and surgery, such as hysterectomy.

Support from a team that cares

Routine Pap smears can detect cervical changes early, often before symptoms appear. Following up after an abnormal result gives you the best chance at avoiding more serious problems in the future.

If you've had an abnormal Pap smear or need your routine screening, we’re here to support you with personalized care and expert guidance. Call our Queens office at 718-793-1995 or our White Plains office at 914-422-0222 to schedule your appointment with Dr. Kushner.