After you’ve had your Pap test, the sample taken by your healthcare provider will be sent to the lab. There, the sample will be examined under a microscope to look for any abnormal changes in the cells. There are a few different ways you may get your results:

• You may hear from your healthcare provider.
• You can contact your healthcare provider if you haven’t heard from them already.
• You will receive a result letter from the Alberta Cervical Cancer Screening Program in Alberta Health Services if you are between the ages of 25 and 69. You will also receive a reminder letter when it’s time for your next Pap test.

There are 3 possible results:

• Your result is normal: This means that no cervical cell changes were found. You should continue with routine screening.
• Your result is unsatisfactory: This means that the lab mostly likely was unable to read the sample. You’ll be asked to repeat your Pap test in 3 months.
• Your result is abnormal: This means that cervical cell changes were found. You should follow-up with your healthcare provider so that changes in the cells of your cervix can be watched closely and treated, if needed.

In Alberta, a Pap test may be followed by a human papillomavirus (HPV) reflex test, if needed.

A normal result means that the Pap test didn’t find any cell changes on your cervix.

What should I do next?

Depending on your previous Pap test results, you may need additional follow-up. Confirm the date of your next Pap test with your healthcare provider.

Remember that a Pap test can miss abnormal cell changes, so it’s important to have regular Pap tests. Keep having regular Pap tests, even if you’re no longer sexually active or have had the HPV vaccine.

An unsatisfactory result most likely means that the lab couldn’t read the sample because there weren’t enough cells or the cells couldn’t be seen under the microscope.

What should I do next?

Make an appointment to have another Pap test in 3 months. It takes about 3 months for the top layers of cells in the cervix to grow back. So it’s important to wait 3 months, or you may have another unsatisfactory result.

Avoid using lubricant/spermicidal gel or douching 48 hours before your Pap test appointment to make sure the result is accurate.

An abnormal result means that the Pap test found cell changes on your cervix.

What causes an abnormal result?

Sometimes infections caused by bacteria or yeast can cause cells to look abnormal under a microscope. However, most often, abnormal Pap test results are caused by HPV.

What should I do next?

Hearing that you have abnormal Pap test results can be stressful. The most important thing you can do for yourself is to go for follow-up appointments to find out if the cells have returned to normal or if they need to be treated, so cancer doesn’t develop.

The next steps depend on the type of abnormal results you have.

• If you have low-grade (minor) cervical cell changes and your Pap test sample wasn’t tested for high-risk HPV: Your healthcare provider will repeat your Pap test in 6 to 12 months. Minor cell changes often go away on their own, and if your cells return to normal, you won’t need treatment.
• If you’re 30 years or older, and the lab sees cell changes that are hard to read, your Pap test sample will be tested for high-risk HPV (HPV reflex testing): If HPV is found, your healthcare provider will refer you for a specialized test called a colposcopy. If HPV isn’t found, you won’t need any further tests until your next regular Pap test.
• If you have low-grade (minor) cervical cell changes that don’t go away, OR if you have high-grade (moderate/severe) changes: Your healthcare provider will likely refer you to a specialist (colposcopist) for a colposcopy to examine your cervix more closely.

• If you have a low grade abnormal result and you’re pregnant, speak with your health care provider to determine your best options. Additional information linked below are for your INFORMATION ONLY. Talk to your health care provider if you have questions.

         Resources:

         Pregnancy and abnormal cervical cells | Cervical cancer | Cancer Research UK

         Cervical-smears-and-pregnancy.pdf (rcog.org.uk)

Making sense of abnormal pap results [brochure]

HPV reflex testing

If you’re 30 years or older, and the lab sees cell changes in your Pap test that are hard to read, your Pap test sample will be tested for HPV. This is called HPV reflex testing. Reflex testing is done because when high-risk HPV is found in women 30 years and older, it’s more likely to be an infection that will last longer. Longer-lasting infections are what cause serious cervical cell changes. Your healthcare provider will want the cells of your cervix looked at more closely.

• If your results show that you don’t have HPV: You won’t need any more testing until your next regular Pap test. Your risk of developing cervical cancer over the next few years is about the same as women who have a normal Pap test result.
• If your results show that you have HPV: This means that the changes seen in your cervical cells were most likely caused by a high-risk type of HPV. Your healthcare provider will refer you for a colposcopy. It’s important to remember that HPV can hide in your body for years without any sign that it’s there.

HPV Testing [brochure]

Colposcopy

A colposcopy is an exam, similar to a Pap test, that is done by a doctor who specializes in women’s reproductive health (a colposcopist). This procedure examines your cervix using a special microscope. The doctor may also take a biopsy (tissue sample) from any areas that appear abnormal for additional testing by the lab.

During the colposcopy:

• The doctor will insert a speculum into your vagina, and then put a mild vinegar solution or iodine solution on your cervix that will cause areas of abnormal cells to change colour.
• The doctor will use a colposcope (a high-powered microscope) to look closely at any abnormal areas of your cervix.

The entire procedure takes less than 10 minutes. If a tissue sample isn’t taken, you shouldn’t feel any discomfort after the procedure.

If a tissue sample is taken, you’ll likely feel some pinching or cramping during the procedure, but the discomfort should go away quickly. There may be some light spotting which should stop within 1 to 2 days.

The following video will give you an idea of what to expect when having a colposcopy:

After a colposcopy exam

If a tissue sample isn’t taken, and the cervical cells appear normal, you may be discharged and referred back to your healthcare provider for routine cervical screening. However, you may be asked to return for another colposcopy exam in 6 to 12 months. It’s important that you return for the follow-up colposcopy so that the cells from each exam can be compared and cell changes can be identified.

If tissue sample was taken, the sample is sent to the lab for further examination. This will help the doctor determine whether you have low-grade or high-grade cell changes.

• Low-grade cell changes: You’ll be followed closely to make sure the cells return to normal. You may have to have a repeat Pap test in several months or another colposcopy.
• High-grade cell changes: Treatment will be recommended so cancer doesn’t develop. Depending on the severity of the high-grade cell changes, treatment may include a loop electrosurgical excision procedure (often called a LEEP) or laser procedure. These procedures remove abnormal cells from the cervix.

The doctor may decide to request that the lab runs an HPV test on the sample. This test is called the HPV Test of Cure and it is used to determine if any HPV subtypes that can lead to cervical cancer are present.

If after the colposcopy or treatment the abnormal changes have gone away on their own or have been treated, you’ll need to see your healthcare provider for regular Pap testing.

• If you had low-grade cell changes: You’ll need to have a Pap test every year for 3 years. If all 3 results are normal, you can likely start having Pap tests every 3 years.
• If you had high-grade cell changes: Your healthcare provider will likely tell you to keep having a Pap test every year to help make sure cervical cancer doesn’t develop.

Colposcopy video series (alberta.ca)