Interpreting Abnormal Pap Tests

Because a Pap test screens for abnormal cervical cells and because those cell changes can be associated with cervical cancer, being on the receiving end of an abnormal Pap test result can be frightening, intimidating, and confusing.

On the “frightening” aspect: Some people assume that an abnormal Pap means that cervical cancer is imminent. On the contrary, the National Cancer Institute not only states that cervical cancer, when it develops, takes “many years” to do so, but also that “[t]he majority of infections with high-risk HPVs [human papillomaviruses] clear up on their own.” This is not to suggest that regular screenings aren’t important — but rather, that they do their job and detect cervical changes in plenty of time to prevent cancer from developing in the first place.


Remember that if you’re confused about your Pap test results, part of your health care provider’s job is to answer your questions and keep you informed.


On the “confusing”: It’s true. There are a lot of different letter codes. Though some of them look awfully similar, they each mean a different thing. Moreover, the clinical recommendations for how to follow up with an abnormal Pap can depend not only on the code — in other words, the specific abnormal result — but also on one’s age and medical history.

Ready to sort them out?

Most labs in the United States use a classification system called the Bethesda System in order to have some standard terminology when reporting results. The Bethesda System uses the term squamous intraepithelial lesion to describe changes on the surface of the cervix. It categorizes those changes in these ways: Continue reading