Pap smear results – what do they mean?

Normal Pap smear result

A normal Pap smear result means that there have been no changes to the cells of your cervix caused by Human Papillomavirus (HPV). Even if your results are normal, you will need to have another Pap smear in two years time.

In the vast majority of cases, Pap smear results will come back normal. In fact, around 93% of Pap smears will be normal.

Abnormal Pap smear result

Just because you have an abnormal result, does not mean you have cervical cancer. An abnormal Pap smear result simply means that some of your cells in your cervix are different to others. These changes can either be classed as low grade or high grade changes.

Low grade changes

Low grade changes are most likely to be caused by the HPV infection. Most cases do not require treatment. However it is important that you continue to monitor your condition. Your doctor will determine your monitoring options based on the following:

• Women under 30 years of age
  If you are under 30 years of age your doctor will recommend you have a follow-up Pap smear in 12 months time. Your result from this follow up test will then determine any further recommendations:
  • normal follow-up result
    If your repeat test is reported as normal your doctor will still recommend a further Pap smear in another 12 months. If this is also normal, you can return to your regular two-yearly Pap smears.
  • abnormal follow-up result
    If either of your repeat tests are reported as abnormal, your doctor will recommend you see a gynaecologist to have a colposcopy.
• Women over 30 years
  If you are over 30 years of age your doctor will base their recommendations on your Pap smear history.
  • normal Pap smear history
    If you have had a normal Pap smear in the last two to three years, a repeat Pap smear in 12 months is recommended.
  • do not have a history of normal pap smears
    If you do not have a history of normal Pap smears in the past two to three years, you will be recommended to have a colposcopy or a repeat Pap smear within six months.

High-grade changes

High-grade changes are more serious changes to the cells of your cervix. These changes have a greater chance of developing into cervical cancer if you leave it untreated.

High grade changes require further investigation, but can usually be treated easily and successfully if detected early. For more information on the treatment options, please see the treatment options page.

Unsatisfactory result

Sometimes your test results will come back as unsatisfactory, this simply means that you will be required to have another Pap smear in six to twelve weeks.

An unsatisfactory result can happen for a number of reasons which include:

• the sample taken contains too much blood
• your cervix was inflamed at the time of your sample
• not enough cells were taken
• the test was not have been properly prepared
• a broken slide.

No endocervical cells present

Sometimes your test results will come back stating that there were no ‘endocervical cells in the sample’. Endocervical cells are the sample of cells comes from the area on the cervix where the squamous cells meet the glandular cells. This is called the transformation zone and is where cancer is more likely to develop. It is sometimes difficult to get a sample of the cells from this area, particularly when a woman is past menopause. This is because the transformation zone tends to move up into the cervical canal at this time of life.

If endocervical cells are not seen on your Pap smear, and you have been having regular smears without abnormal results, and you have no symptoms (such as unexplained bleeding), you do not need another Pap smear before the usual two year interval.

If endocervical cells are not seen on your Pap smear, and you have been having regular tests, you do not need another one before the usual two-year interval.