Cervical Cancer: When Your Pap Test Is Abnormal

Regular cervical cancer screenings let you know if something is wrong before you have any symptoms. The earlier your healthcare provider finds any problems, the easier they usually are to treat.

If your healthcare provider contacts you to say your Pap test results are abnormal, try not to panic. This just means there are cells on your cervix that don’t look like normal healthy cells. These cell changes may be classified as mild, moderate, or severe. They often change due to factors such as:

  • Infection
  • Inflammation
  • Precancer
  • Cancer

What abnormal cell changes mean

Your healthcare provider may use any of these terms to describe the changes that aren't cancer:

  • Atypical squamous cells of uncertain significance (ASC-US)—the most common abnormal finding
  • Squamous intraepithelial lesion (SIL)
  • Cervical intraepithelial neoplasia (CIN)
  • Dysplasia
  • Atypical glandular cells (AGC)

With ASC-US, your provider will usually tell you to get rechecked with another Pap test in 6 months to a year. Another option is to test for HPV and use the information from both tests to decide on the next steps.

When you hear SIL, this means abnormal cells were found on the surface of the cervix. They’re usually classified as low-grade SIL (LSIL) or high-grade SIL (HSIL).

  • In LSIL, the cells look mildly abnormal. This might also be called CIN1 and mild dysplasia. It might go away without treatment.
  • HSIL means there are seriously abnormal cells. They are less likely to go away on their own. They are also more likely to become cancer over time if they aren’t treated. This is also called CIN2 or CIN3 and moderate to severe dysplasia. CIN3 is the most serious precancer.

AGC means that the glandular cells are abnormal. They have features that could be cancer or precancer.

Next steps

If an abnormal growth is confirmed to be LSIL, CIN1, or mild dysplasia, your healthcare provider may simply watch you closely over time. HPV testing can confirm if HPV infection caused the abnormal cells. You should have repeat Pap and HPV tests to know if the cells return to normal.

If you have HSIL, CIN2 or 3, moderate to severe dysplasia, or AGC, the next step is usually a colposcopy. This procedure lets your provider closely examine your cervix using a special magnifying scope. A biopsy may be done to remove more tissue to be checked for abnormal cells.

In most cases, precancer can be treated in your provider’s office or in a hospital as an outpatient. This means you go home the same day. Surgery is rare for precancer of the cervix.

If you have any questions about your Pap test results, talk with your provider. And remember that the earlier cervical cell changes are found, the easier they are to treat.