Abnormal Pap Test - Treatment Overview
Even though most
abnormal Pap tests are caused by an
HPV infection that will go away or by an inflammation
that can be treated, you will need a follow-up evaluation to make sure your
abnormal cell changes have resolved. Your need for treatment will vary
depending on whether your abnormal cell changes are mild, moderate, or severe.
Abnormal Pap test results may show minor cell changes (most common), moderate
to severe cell changes (less common), or
cervical cancer (rare). Depending upon the cause and
severity of the cervical cell changes,
you may need treatment.
If your Pap test shows that a vaginal infection or a treatable
sexually transmitted infection (STI) is present, you can
be treated with medicine.
Human papillomavirus (HPV) infection is the most
common cause of an abnormal Pap test. There are many types of HPV. High-risk
types can cause cell changes that could develop into cancer.
Evaluation of minor cell changes (ASC-US and LSIL)
An abnormal Pap test result is not uncommon because HPV infection is
very common. Most cell changes seen in abnormal Pap test results will not
progress to cervical cancer. If your abnormal Pap test shows
minor cell changes, you may have several choices of what to do next.
Based on your age and the type of cell changes found, your doctor may recommend:
Watchful waiting, which includes repeat Pap tests
about every 6 months, or less often if you are under 21. Watchful waiting will not be harmful if the abnormal
tissue is not visible on the cervix or a type that is not likely to progress to
cancer and you do not have an
impaired immune system.
- A test for high-risk human papillomavirus (HPV) types.
The natural course of most types of HPV is to resolve on their own within 18
months. HPV in women younger than 30 usually goes away on its own. HPV in women
older than 30 is more likely to persist.
- A colposcopy so your doctor can look at the abnormal
cervical biopsy may be done at the same time to
confirm the colposcopy findings. Women with HIV infection will most likely be
evaluated with colposcopy and then treated for any abnormal cervical
For more information, see:
Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?
Treatment for moderate to severe cell changes (HSIL, ASC-H, or AGC)
Treatment decisions for an abnormal Pap test that shows
moderate to severe cell changes are based on the Pap
test results, colposcopy, and cervical biopsy. A larger tissue sample may be
removed by a
cone biopsy. In some cases, this procedure may serve
as treatment so you are cured. Follow-up to evaluate and treat moderate to
severe cervical cell changes is recommended sooner than for minor cell changes.