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Abnormal Pap Test - Exams and Tests

You may have a Pap test as part of your routine gynecologic exam. A Pap test is used to identify abnormal cell changes on your cervix and to screen for cervical cancer. Pap test screening is the most effective way to detect early abnormal cervical cell changes.

Women older than age 30 may have a screening test for HPV infection at the same time they have their Pap test.1

Pap test screening schedule

The recommended Pap test schedule is based on your age and on things that increase your risk. For most women, it is best to have a Pap test every 1 to 3 years. Talk to your doctor about when to have your first Pap test and how often to have this test.

Abnormal Pap test result

If your Pap test result is abnormal, the lab will use the Bethesda system (TBS) to describe how severe the problem is. Your doctor will use these results to decide how to treat the problem.

Following an abnormal Pap test result, more tests may be needed to determine whether an infection is present or to determine the severity of cervical cell changes. These additional tests include:

  • Human papillomavirus (HPV) DNA test. HPV testing is done to identify high-risk types of HPV infection. If your abnormal Pap test is caused by HPV, knowing whether you have a high-risk type of HPV can help guide your evaluation and treatment decisions.
  • Colposcopy and cervical biopsy. A colposcopy uses a magnifying instrument called a colposcope to look at the vagina and the cervix. Cell abnormalities (dysplasia) that might be missed by the naked eye can be seen with the colposcope. A cervical biopsy removes a small piece of the cervix so the tissue can be examined under a microscope.
  • Cone biopsy. This is an extensive form of a cervical biopsy. It is called a cone biopsy because a cone-shaped wedge of tissue is removed from the cervix and examined under a microscope. A cone biopsy may also serve as treatment by removing the abnormal cervical cells.

For more information, see:

dplink.gif Pap Test: Should I Have Colposcopy if My Pap Test Shows Minor Cell Changes?

For information on tests to diagnose a specific infection, see the specific topic:

  • Genital Warts (Human Papillomavirus)
  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Genital Herpes
  • Trichomoniasis
  • Bacterial Vaginosis
  • Vaginal Yeast Infections

What to think about

Testing methods, such as liquid-based collection, are being used in many areas of the United States. Liquid-based collection methods allow testing for HPV at the same time as a Pap test, but these methods may not be available everywhere and may be more costly.

The terms used to report Pap test results vary depending on which classification system is used. The Bethesda system (TBS) is used by most labs in North America. Other classification systems are used around the world.

  • The Bethesda system (TBS) classifies cervical cell changes by type of abnormality, such as atypical squamous cells (ASC).
  • Older classification systems use the term dysplasia to describe cervical cell changes or describe the changes as mild, moderate, or severe.
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WebMD Medical Reference from Healthwise

Last Updated: October 17, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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