When your doctor says, "We need to talk about your Pap Smear," it's natural to jump to the wrong conclusion.  Worst case scenario: Your abnormal pap smear means cervical cancer.  More likely scenario? Something else is going on that's far less scary.

Pap smears are simple lab tests performed in the doctor's office, usually part of an annual well-woman exam. Your health care provider gently scrapes cells off your cervix (the lower part of the uterus that extends into the vagina). Usually, pap smear results are negative, indicating your cervix is healthy.  Sometimes however, pap smears indicate an infection, unhealthy cervical cells, human papilloma virus, and/or cervical cancer. 

According to the National Cancer Institute, about 55 million pap smears are performed each year and of those, only 3.5 million are abnormal, requiring further medical follow-up. The National Cervical Cancer Coalition estimates that about 10,000 American women are affected by cervical cancer annually. That means that most abnormal pap smear results are not cancer.

Women may hear one of these terms used to describe her abnormal Pap Smear results:

  • Dysplasia. These cervical cells are not cancer but they may develop into very early cancer eventually. They look abnormal under the microscope but they don't spread to nearby healthy tissue. Dysplasia is usually classified as mild, moderate, severe or carcinoma in situ (abnormal cells are present only in the surface layer of cells).
  • SIL (squamous intraepithelial lesion). This term describes abnormal changes in the squamous cells on the surface of the cervix.  They can be low-grade (early changes in size, shape and number of cells) or high-grade (pre-cancerous and very different from normal cells).
  • CIN (cervical intraepithelial neoplasia). This refers to abnormal tissue findings.  Neoplasia means abnormal growth of cells and intraepithelial cells are surface cells. CIN is rated from one to three, depending on the thickness of abnormal cells.
  • Atypical squamous cells. They aren't a definite abnormality but there's something different about the cervical cells that warrants further investigation.

With cervical cancer, abnormal cells spread deeper into the cervix or to other tissues or organs.  Cervical cancer is usually (but not always) a slow growing disease. Incidences of cervical cancer have been steadily declining over the years in large part due to pap smears.  Experts have also learned that the majority of cervical cancer cases are caused by Human Papilloma Viruses, and young girls and women can be vaccinated against it. 

What if your pap smear is abnormal? First, take a deep breath and remember that the vast majority of abnormal pap smears are not cancer. Next, make a follow up appointment with your doctor for further examination. Most abnormal cervical cells can be treated and never turn into cancer. Talk to your doctor about how often you need to get a pap smear.



National Cervical Cancer Coalition



National Cancer Institute: Pap Tests