What Does an Abnormal Pap Smear Mean? - Common Causes and Test Results

Movies and TV shows may make Pap smears look scary, but they're an important part of reproductive health. What actually happens during a Pap smear, and what do you need to know about getting abnormal results? Allure talked Hilda Hutcherson, an obstetrician/gynecologist and professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons, about all things Pap smears.

What does a Pap smear do, and how often should people with cervixes get one?

Hutcherson says that Pap smears are tests that look at cells from the cervix for changes that suggest pre-cancer or cancer. The test usually involves a medical professional inserting a speculum and "scraping" the cervix with a small cotton swab or other instrument to obtain cells.

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In terms of frequency of Pap smears, most people get their first Pap at age 21, and Hutcherson notes that the current recommendation is that tests are administered every three years from ages 21 to 29. Once a patient turns 30, doctors typically add an HPV test in addition to a routine Pap smear, and if a patient has "normal" Pap smears, these tests continue to be administered every five years.

Do patients need to do anything to prepare for a Pap smear?

Patients don't need to take any additional steps before a Pap smear, but there are a few things they shouldn't do. "Avoid intercourse and douching at least 48 hours before [the test], because cells may be removed with both [behaviors] and decrease accuracy of the pap," Hutcherson explains.

What does it mean when someone has an abnormal Pap smear?

Hutcherson says that a result marked as "abnormal" means that cells that were removed are showing changes that may be caused by an infection, pre-cancer, or cancer. The key word here, however, is may. A Pap smear itself isn't a diagnosis; it's just the first step on the path to finding one, and while it does require further examination, an abnormal test result isn't reason enough to panic.

What are a patient's options if they get an abnormal Pap smear?

Doctors usually recommend further testing to discover the cause of the abnormal Pap smear. Hutcherson notes that sometimes that means just repeating the Pap smear or treating an infection and repeating it. Other times, a doctor may do a colposcopy, where the cervix is examined under a microscope to get a better sense of what changes it's undergoing.

What can women do to take care of their reproductive health?

The biggest thing Hutcherson recommends is getting regular check-ups. "Paps are recommended every three years, but you should have an exam yearly to check for infections and other abnormalities in your reproductive track," she says. She also says women should test for STIs at least annually, as well as after starting a sexual relationship with a new partner.

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