What Your Pap Smear Results Mean

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A Pap smear, also called a Pap test, checks for cervical cancer. For the test, your doctor uses a long swab or brush to swipe your cervix and collect cells. A laboratory examines the cells. There are three possible results: normal, abnormal or inconclusive. They are somewhat vague terms that don’t provide a full explanation.

Here's what these results really mean.

Normal Pap

A Pap smear checks for any cells that don’t look healthy and normal and may be cancerous. A normal result means that all of the cells in your cervix look healthy and normal. They are not cancerous.

A normal result is good news. Still, regular tests are important. Pap smear results aren't accurate 100% of the time. It's possible for the test to miss some abnormal, cancerous cells and indicate that your result is normal. This is a false negative. Cervical cancer grows slowly. If your Pap smear missed cancerous cells, another Pap smear the next year may find them.

Abnormal Pap

There are different types of abnormal results. The test might find cells that look only slightly different than normal cervical cells. They would not need treatment. The results will say you have LSIL (low-grade dysplasia). Cells that are more abnormal, or even very abnormal, indicate HSIL (high-grade dysplasia). Another name for this is carcinoma in situ. Over time, these cells turn into cancer.

An abnormal result also may indicate cervical cancer (squamous cell carcinoma of the cervix). This means that abnormal cells progressed to cancer and may affect organs and tissues outside the cervix. This result is rare for women who get regular screenings. This type of cancer grows slowly. Getting Pap smears on a regular basis should catch the cells before they become cancerous.

It's also possible an abnormal Pap smear result is wrong. A result might show abnormal cells when there actually aren't any. That's a false positive. Your doctor can tell you if your results are accurate and if additional testing is necessary. For instance, your doctor may want to look more closely at your cervix with a magnifying device called a colposcope.

Inconclusive Pap

Inconclusive results mean that some cells aren't typical, but there's no clear diagnosis. The report on your Pap smear usually says you have one of two types: ASCUS (atypical squamous cells of undetermined significance) or AGCUS (atypical glandular cells of undetermined significance). The unusual cells could indicate you have human papillomavirus (HPV), the virus that can cause cervical cancer. Or, they might be signs of cervical cancer.

Your doctor may do another Pap smear in six months or a year. Or, you might need some other tests right away to figure out why the cells are abnormal.

It's also possible your doctor didn't get a good sample of cervical cells during the Pap smear. In that case, the report on your test would say "unsatisfactory." You may need another test to get a clear result.

Future Testing

Your Pap smear results determine when you'll need your next Pap smear.

If you've had a normal result, you probably won't need another Pap smear for at least three years. If your result was abnormal or inconclusive, you may need more frequent Pap smears. Or, you might need more tests, such as colposcopy or an HPV test, to help your doctor determine why the cells are abnormal. Cervical cancer screening recommendations for most women are a Pap test every three years, an HPV test alone every five years, or a combined HPV-Pap test (co-testing) every five years. The recommendation for women 21 to 29 is a Pap test every three years. 

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 15
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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  2. Pap Test. Lab Tests Online. https://labtestsonline.org/understanding/analytes/pap/tab/test/

  3. Pap and HPV Testing. National Cancer Institute. http://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet#q7

  4. Pap Smear. Mayo Clinic. http://www.mayoclinic.org/tests-procedures/pap-smear/basics/definition/prc-20013038

  5. Pap Test. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/003911.htm

  6. Pap Test. Office on Women's Health. http://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.html 
  7. Screening for Cervical Cancer US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674-686. https://jamanetwork.com/journals/jama/fullarticle/2697704

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