Pap smear fear: What happens after an abnormal result?

Reality show legend Nicole Polizzi, famously known as Snooki on “Jersey Shore,” shared on social media earlier this year that she had abnormal Pap smear results and recently revealed she has stage 1 cervical cancer. Polizzi shares her health journey in hopes to bring awareness to the importance of preventive screening and what you can expect along the way.

What is a Pap smear?

A woman’s annual gynecology appointment may sometimes include a Pap smear to screen for cervical cancer.

“A Pap smear involves your health care provider collecting a small sample of cervical cells during your pelvic exam,” explains Dr. Samantha Lauhon, an OB-GYN physician at Aurora Health Care. “This sample will allow us to see if your cervical cells are normal, precancerous or cancerous.”

An abnormal result doesn’t necessarily mean you have cervical cancer. Instead, it might be caused by human papillomavirus (HPV) or be a sign you may have cells that have a higher potential to turn into cancer without proper medical intervention.

“Early detection is key,” Dr. Lauhon says. “A Pap smear allows us to see if you have cells that are likely to turn into cancer in the future. If you don’t get a Pap smear, you won’t get the chance to intervene and put a stop to the cervical cancer.”

Who should get a Pap smear?

The cervical cancer screening options vary depending on your age. It’s recommended women ages 21 to 29 receive a Pap smear every three years.

Women aged 30 to 65 have a few variations of screening available:

• A Pap smear every three years and an HPV test every five years
• Co-testing, doing both tests at the same appointment, every five years

What happens after abnormal Pap smear results?

If you received a Pap smear and the results come back abnormal or HPV positive, your health care provider will recommend follow-up care based on your individual health background and test results.

“Next steps vary for each person,” Dr. Lauhon says. “Your health care provider may recommend that you repeat the HPV screening and/or get a colposcopy for further investigation.”

During a colposcopy, a magnifying tool called a colposcope is used to make it easier to see the cervix and vagina. A solution on a cotton swab is applied to these areas to detect abnormal spots. During this procedure, abnormalities will be biopsied by removing a small sampling of tissue.

What happens after a biopsy?

Your biopsy results can come back normal or abnormal. Abnormal results can vary in severity and will influence your treatment options.

“If the abnormal cells are considered low grade, this is most likely due to inflammation from the HPV virus. Your health care provider may recommend a repeat screening in a year or so to see if the HPV resolves on its own,” Dr. Lauhon explains.

Higher grade abnormal cells that are precancerous require full removal to prevent the development of cervical cancer. Common treatment options include:

• Loop electrosurgical excision procedure (LEEP). Using local anesthesia, this procedure uses a wire loop with an electrical current to remove abnormal cells.
• Cone biopsy. This procedure removes your abnormal cells by taking out a cone-shaped piece of tissue. This procedure requires you to go under anesthesia.

“As scary as an abnormal, or positive, Pap smear or HPV test result seems, it’s important to remember that 40% of women who receive a colposcopy end up having a normal result,” Dr. Lauhon reassures. “If you do have an abnormal result, it’s very likely that you caught the abnormal cells early, which means there are many successful treatment options to prevent the cells from progressing into cancer.”

Your OB-GYN provider can help address any questions you may have about cervical cancer screening options and your overall risk.

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