Abnormal HPV and/or Pap test? Here's what to expect

You’ve gotten the results of your HPV and/or Pap test back — and they were abnormal.

But what does that mean? Is that the same thing as having cervical cancer?

The good news is that most women with abnormal HPV and/or Pap test results are perfectly healthy. Here’s what to know about their connection to cervical cancer.

How serious is an abnormal HPV and/or Pap test?

An abnormal HPV and/or Pap test doesn’t mean that you have cancer right now or that you’ll definitely have it at some point in the future. It just means you have cells on your cervix which don’t look normal under a microscope.

This fairly common condition is known as “cervical dysplasia,” or pre-invasive cervical disease. In most cases, women with abnormal screening results won’t end up developing cervical cancer. But some will have a precancerous condition, which is very treatable.

What should I do if my HPV and/or Pap test is abnormal?

Seek follow-up care. That way, a medical provider can evaluate you and come up with a treatment plan to make sure the abnormal cells don’t turn into cancer. And, if they do turn into cancer, your provider can also catch it early, when it’s most treatable.

When we see someone who’s had an abnormal cervical cancer screening test here at UT MD Anderson, we typically do a pelvic exam with a colposcopy and cervical biopsies. A colposcopy is a procedure in which a medical provider closely examines your cervix with a special device called a colposcope.

If we find cells that demonstrate high-grade dysplasia, then you may also need a loop electrosurgical excision procedure (LEEP). That procedure uses a wire loop heated with an electrical current to remove abnormal cells from the cervix.

Do I need to see a special kind of doctor after an abnormal HPV and/or Pap test?

Not necessarily. Just make sure your medical provider performs a colposcopy and cervical biopsies. That’s the best way to ensure you receive the correct diagnosis and treatment.

What happens during a colposcopy?

First, we put acetic acid on your cervix so it’s easier for us to see any abnormal areas. Then, we examine your cervix carefully using a colposcope. If we notice anything abnormal, we'll biopsy those areas and send the tissue samples off to a lab for analysis. It typically takes about one to two weeks to get the results.

Since no anesthesia or only local anesthesia is sometimes applied, colposcopy and biopsies are performed in an outpatient setting.

What if my biopsy results are abnormal, too?

If we diagnose high-grade dysplasia, we’ll need to remove the abnormal tissue. Usually, we can accomplish this in the clinic using a LEEP.

But if we’re concerned that you might have a more serious diagnosis, we’ll perform a cold knife cone (CKC) biopsy in an operating room instead. This is a more extensive procedure in which a cone-shaped wedge of abnormal tissue is removed from higher up in the cervical canal. Because that area is harder to reach, a cone biopsy requires general anesthesia.

What kind of follow-up care do I need after a colposcopy?

If the cervical dysplasia is low-grade, you’ll just need to see your medical provider again in one year. If it’s high-grade dysplasia, you’ll need an appointment much sooner for a LEEP— normally within 4-8 weeks of your colposcopy. After the LEEP, you’ll need to return in six months, depending on the results.

Of course, if you notice any changes in your body before then, see a doctor sooner.

What causes an abnormal HPV and/or Pap test?

Abnormal cell changes in the cervix are usually caused by the human papillomavirus (HPV). HPV infections usually clear up on their own. But if it persists and is left untreated, it can cause high-grade dysplasia and progress to cervical cancer.

Kathleen Schmeler, M.D., is a gynecologic oncologist and associate vice president of Global Oncology at UT MD Anderson.

Request an appointment at UT MD Anderson online or call 1-877-632-6789.