There are a number of different Pap smear results that may require follow-up. Some of these are related to the quality of the Pap smear whilst others may be related to precancerous changes. Your health care provider can discuss your result with you in detail. The following information provides a brief outline of the types of results that may be reported by the laboratory.
Unsatisfactory Smear
This means there was a technical problem with the smear and the laboratory staff cannot see the cells clearly enough to give a full report. Your Pap smear provider may ask you to have a repeat smear even though no abnormal cells were detected.
Inflammatory Smear
Sometimes a Pap smear will show signs of inflammation. This may be caused by an infection caused by a micro-organism such as Candida Albicans or Trichomonas. Sometimes the cause of the inflammation may be detected by the Pap smear, however further investigations should be undertaken to identify and treat the cause.
Atrophic Smear
An atrophic smear can be difficult for the laboratory to interpret. Atrophic Pap smears are often seen in breast feeding women or women after menopause. These Pap smears result from decreased hormone levels, particularly oestrogen. It is recommended that the woman has a repeat smear in 3 months after being treated with local oestrogen (for example, oestrogen cream).
Possible low-grade squamous intra-epithelial lesion
These are changes in the cells of the cervix that may represent a low-grade abnormality, but the changes are not enough to justify a 'definite' diagnosis.
Low-grade squamous intra-epithelial lesion
This is a low grade abnormality that indicates cell changes are present that are most likely due to infection with HPV. The follow-up of women with possible or definite low-grade abnormalities is generally the same, but may vary according to your age and whether you have had abnormal results in the past. Your Pap smear provider will explain the follow-up you require.
Possible high-grade squamous intra-epithelial lesion
This means a high-grade abnormality is suspected but the changes are not clear enough to justify a 'definite' diagnosis.
High-grade squamous intra-epithelial lesion
This is a high-grade abnormality that suggests there are cell changes in the cervix that require further investigation. These changes are still precancerous changes (changes that occur before cancer develops) and your health care provider will advise the follow-up required for this abnormality.
Glandular abnormalities
Glandular abnormalities are seen in cells from the top part of the cervix that leads to the uterus or womb.
There are three types of glandular abnormalities:
All glandular abnormalities are referred to as high grade abnormalities and require further investigation.
| Ask your Pap smear provider to explain exactly what your Pap smear result means. Make sure you understand what happens next and why. This can save you a lot of needless worry. |
Further investigations and follow-up
The type of follow-up you require will depend on whether you have had any previous abnormal Pap smears, your age and your result. Sometimes the only follow-up you will need will be another Pap smear. A colposcopy is also commonly recommended after an abnormal Pap smear.
What is a colposcopy?
This is a magnified examination of the cervix undertaken by a specialist. It usually takes about 15 minutes and is a similar procedure to a Pap smear. It is not an operation and no anaesthetic or hospital stay is necessary.
A colposcope is a special microscope on a stand. It is positioned outside your body. The specialist then looks through the colposcope at your cervix and vagina and can see abnormal areas that are otherwise invisible to the naked eye.
For more information on colposcopies please refer to the Colposcopy information sheet.
What is a biopsy?
During colposcopy the specialist will use a harmless solution on your cervix to highlight any abnormal looking areas of the cervix and may take a tiny piece of tissue (a biopsy) for further examination. This may sting for a short time. The biopsy is sent to a pathology laboratory to be examined and the results are usually available within 1-2 weeks.
What if I need treatment?
If you need further treatment your doctor will discuss this with you when you have your colposcopy, or when your biopsy results have come back from the pathology laboratory.
Feel free to ask as many questions as you like so that you understand what is going on and why. There is a list of questions following that you may find useful.
There are a variety of treatments available. Your treating doctor will discuss with you the best form of treatment for you.
Questions you may want to ask your doctor
After an abnormal Pap smear:
After colposcopy/biopsy:
For more information on abnormal results you can view the booklet: An abnormal Pap smear result - What this means for you or contact your Pap smear provider.
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