A Pap smear is a routine screening test that examines cells from the cervix under a microscope. Its purpose is to catch abnormal cell changes early, before they have a chance to develop into cervical cancer. A human papillomavirus (HPV) test, which is sometimes done at the same time, checks for high-risk strains of HPV that can drive those cell changes over time. Together, these two tests are the foundation of cervical cancer prevention.
Most abnormal results do not mean that you have cancer. They usually mean your care team found changes that need monitoring, additional testing, or treatment to prevent problems down the road.
How the two tests work together
A Pap smear identifies what is happening at the cellular level on the cervix. An HPV test tells your provider whether a high-risk virus is present that could cause future changes. You may have one test or both, depending on your age, screening history, and what your provider recommends.
From ages 21 to 29, a Pap test is typically recommended every three years. From ages 30 to 65, options include HPV testing every five years, a Pap test every three years, or both tests together every five years. Your provider will help determine which schedule makes sense for you. These screenings are typically part of your annual exam or well-woman visit.
What happens during a Pap smear
The test is done during a pelvic exam. A speculum is placed in the vagina so the cervix is visible, and a soft brush collects a small sample of cells. Most women feel pressure or mild discomfort, but it should not be intensely painful. The sample goes to a lab, and results typically come back within a couple of weeks.
To get the most accurate results, try to avoid scheduling during heavy menstrual bleeding. In the two days before your test, it helps to skip douching, vaginal medications unless prescribed, and scented products. If you tend to feel anxious during pelvic exams, let your care team know ahead of time. They can adjust their approach to make the experience more comfortable.
Understanding your results
Results use medical terms that can be confusing. Here is what the most common findings mean.
A normal result means no abnormal cells were found. If your HPV test is also negative, your risk is low and you can follow routine screening intervals.
ASC-US stands for “atypical squamous cells of undetermined significance.” This is one of the most common abnormal findings. It often reflects minor, temporary changes. Depending on your age and HPV status, the next step may be repeat testing in a year.
LSIL stands for “low-grade squamous intraepithelial lesion.” This usually reflects mild cell changes related to HPV that frequently resolve on their own. Your provider may recommend repeat testing or a colposcopy depending on your history.
HSIL stands for “high-grade squamous intraepithelial lesion.” This suggests more significant changes with a higher chance of progressing if untreated. HSIL results often lead to colposcopy, and treatment may be recommended more quickly.
AGC stands for “atypical glandular cells.” These results require careful follow-up, which may include colposcopy and additional evaluation depending on your age and symptoms.
What happens during follow-up?
Follow-up depends on your current result combined with your past screening history. For mild findings, the next step may simply be repeating your Pap or HPV test in 12 months, since many HPV-related changes resolve naturally.
If closer evaluation is needed, your provider may recommend a colposcopy. This is an in-office procedure where a special magnifying instrument is used to examine the cervix more closely. A solution may be applied to highlight abnormal areas, and small biopsies may be taken if needed. Biopsies can cause brief cramping and some spotting afterward, but your care team will walk you through what to expect.
If biopsy results show moderate to severe precancerous changes, treatment to remove the abnormal cells may be recommended. One common option is a LEEP procedure, which removes the affected area of the cervix. The goal of any treatment at this stage is prevention, not a response to cancer that has already developed.
Common questions about HPV results
A positive HPV result does not mean you have cancer. HPV is extremely common, and most sexually active adults will be exposed at some point in their lives. Most infections clear on their own without causing any problems. The concern is when high-risk HPV types persist over time, which is exactly what regular screening is designed to monitor.
A question that comes up often is whether a positive result means a partner was unfaithful. HPV can stay dormant for years, so a positive result does not tell you when or from whom exposure occurred. Your care team can talk through what it means without judgment.
What a Pap smear cannot do
A Pap smear does not screen for ovarian cancer, and it does not diagnose yeast infections or bacterial vaginosis. It also may not detect sexually transmitted infections like chlamydia or gonorrhea unless specific STI testing is ordered separately.
If you are experiencing symptoms like unusual discharge, pelvic pain, pain with sex, or bleeding between periods, bring those up with your provider. Those concerns may need separate evaluation as part of your gynecology care.
The role of the HPV vaccine
The HPV vaccine protects against the HPV virus types most commonly linked to cervical cancer. Even if you have already been exposed to HPV, vaccination may still provide protection against types you have not encountered. Eligibility depends on age and health history, so ask your provider whether it is appropriate for you. Vaccination does not replace screening. Both play a role in prevention.
Take charge of your cervical health
Cervical screening is one of the most effective tools available for preventing cervical cancer, and understanding your results puts you in a stronger position to stay on top of your health. If you are due for a Pap smear, have questions about an abnormal result, or want to discuss HPV testing, schedule an appointment with Care for Women’s Medical Group. Our team is here to explain your results clearly and guide you through any next steps you may need.
