Abnormal Pap test? What to know about cervical dysplasia

So, you’ve been through the discomfort and awkwardness of your Pap test, and you’ve gotten the unexpected call from your doctor: Your Pap test was abnormal. Now what?

We recently spoke with Kathleen Schmeler, M.D., co-leader of MD Anderson’s HPV-Related Cancers Moon Shot™, to find out what you should know. Here’s what she had to say.

What does it mean when my doctor says I have an abnormal Pap test?

An abnormal Pap test result means there are cells on your cervix that don’t look normal under a microscope. This fairly common condition is known as cervical dysplasia, or pre-invasive cervical disease.

Does my abnormal Pap test mean I’m going to have cervical cancer?

An abnormal Pap test doesn’t mean you have cancer or that you’ll have cancer in the future. In most cases, women with an abnormal Pap test don’t end up developing cervical cancer. But some do have pre-cancer, which is very treatable.

What causes an abnormal Pap test?

Abnormal cell changes in the cervix are often caused by the human papillomavirus (HPV). Usually, HPV infections clear up on their own. But some HPV strains can cause high-grade dysplasia and several types of cancer, including cervical cancer.

Sometimes, abnormal cells are caused by a yeast infection or a bacterial infection, both of which are very treatable. Or, if you’ve already been through menopause, these cell changes may be the result of age.

A weakened immune system and HIV can also make you more likely to have an abnormal Pap test.

But most women with abnormal Pap test results are perfectly healthy.

What’s the difference between low-grade and high-grade cervical dysplasia?

Low-grade cervical dysplasia typically goes away on its own. But if you have high-grade cervical dysplasia, the cells are more abnormal and need to be treated because they can turn into cancer.

What do I need to do now that I have an abnormal Pap test?

When we see a woman who’s had an abnormal Pap test at MD Anderson’s Colposcopy Clinic, we typically do a pelvic exam with a colposcopy and cervical biopsies. A colposcopy is a procedure where a doctor closely examines your cervix with a special instrument called a colposcope.

If you’re diagnosed with high-grade dysplasia, the doctor may need to do a loop electrosurgical excision procedure (LEEP). This procedure removes abnormal cells from the cervix using a wire loop heated by an electrical current.

What kind of doctor do I need to see?

Make sure you see a gynecologist or gynecologic oncologist who’s done a lot of colposcopies. This is the best way to ensure you receive the correct diagnosis and treatment the first time.

What happens during a colposcopy?

During a colposcopy, we put acetic acid on the cervix so that it’s easier to see the abnormal areas with a colposcope. It can be performed in the clinic and doesn’t require anesthesia. If we see anything abnormal during the colposcopy, we’ll biopsy those areas.

It typically takes about a week to get the biopsy results.

What if my biopsy results are abnormal?

If we see significant cell changes, we’ll remove the abnormal tissue. Usually, we’ll do this in the clinic using a LEEP.

But if we’re concerned a patient may have cancer, we do a cone biopsy in the operating room. This is a more extensive biopsy in which a cone-shaped wedge of abnormal tissue is removed from higher up in the cervical canal. Because that area is harder to get to, this procedure requires general anesthesia.

What kind of follow-up care will I need after my colposcopy?

If the cervical dysplasia is low-grade or normal, you’ll need to see your doctor in a year. If it’s high-grade, you’ll have an appointment much sooner — just four weeks after your LEEP — and then have a follow-up appointment in a year, depending on the results.

Of course, if you notice any changes in your body before your next appointment, see your doctor sooner.

Anything else you want women to know about abnormal Pap test results?

Make sure you get follow-up care when you find out your Pap test is abnormal. That way, your doctor can monitor you and come up with a treatment plan to make sure the abnormal cells don’t turn into cancer. And, if these cells do turn into cancer, your doctor can catch the cancer early, when it’s most treatable.

MD Anderson’s Colposcopy Clinic offers diagnosis and treatment for cervical dysplasia. Request an appointment online or by calling 1-877-632-6789.