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Showing content from https://www.cancer.gov/types/cervical/screening/abnormal-hpv-pap-test-results below:

HPV and Pap Test Results: Next Steps after an Abnormal Test

HPV test results: What positive and negative results on a screening test mean

HPV test results show whether high-risk HPV types were found in cervical cells. An HPV test will come back as a negative test result or a positive test result.

What does it mean if you have a positive HPV test after years of negative tests?

Sometimes, after several negative HPV tests, a woman may have a positive HPV test result. This is not necessarily a sign of a new HPV infection. Sometimes an HPV infection can become active again after many years. Some other viruses behave this way. For example, the virus that causes chickenpox can reactivate later in life to cause shingles.

Researchers don’t know whether a reactivated HPV infection has the same risk of causing cervical cell changes or cervical cancer as a new HPV infection.

Pap test results: What normal, abnormal, and unsatisfactory screening test results mean

Pap test results show whether cervical cells are normal or abnormal. A Pap test may also come back as unsatisfactory.

Normal Pap test results: No abnormal cervical cells were found. A normal test result may also be called a negative test result or negative for intraepithelial lesion (area of abnormal growth) or malignancy.

Unsatisfactory Pap test results: The lab sample may not have had enough cells, or the cells may have been clumped together or hidden by blood or mucus. Your health care provider will ask you to come in for another Pap test in 2 to 4 months.

Abnormal Pap test results: An abnormal test result may also be called a positive test result. Some of the cells of the cervix look different from the normal cells. An abnormal test result does not mean you have cancer. Your health care provider will recommend monitoring, more testing, or treatment.

Abnormal Pap test results include

Follow-up tests and procedures after an abnormal Pap test (Pap smear) or HPV test

Keep in mind that most people with abnormal cervical screening test results do not have cancer. However, if you have an abnormal test result, it’s important to get the follow-up care that your health care provider recommends.

Until recently, follow-up recommendations were based on the results of a person's most recent cervical screening test. However, updated ASCCP risk-based management consensus guidelines advise a more tailored approach to follow-up care.

What these updated guidelines mean is that, in addition to your current Pap, HPV, or cotest screening result, your health care provider will consider additional factors when recommending follow-up care, including

Based on your individual risk of developing severe cervical cell changes that could become cervical cancer, you may be advised to

These updated guidelines focus on detecting and treating severe cervical cell changes that could develop into cervical cancer while also decreasing testing and treatment for less severe conditions (low-grade cervical cell changes).

Colposcopy

During a colposcopy, your doctor inserts a speculum to gently open the vagina and see the cervix. A vinegar solution is applied to the cervix to help show abnormal areas. Your doctor then places an instrument called a colposcope close to the vagina. It has a bright light and a magnifying lens and allows your doctor to look closely at your vagina and cervix for abnormal areas.

A colposcopy usually includes a biopsy, so that the cells or tissues can be checked under a microscope for signs of disease, including cervical cancer.

Cervical biopsy

A biopsy is a procedure used to remove cervical cells or tissue to be checked under a microscope for abnormal cervical cells, including cancer. In addition to removing a sample for further testing, some types of biopsies may be used as treatment, to remove abnormal cervical tissue or lesions.

Talk with your doctor to learn what to expect during and after your biopsy procedure. Bleeding and/or discharge after a biopsy may occur. Some people have pain that feels like cramps during menstruation.

Biopsy findings: cervical intraepithelial neoplasia (CIN)

Biopsy samples are checked by a pathologist for CIN. CIN is the term used to describe abnormal cervical cells that were found on the surface of the cervix after a biopsy.

CIN is graded on a scale of 1 to 3, based on how abnormal the cells look under a microscope and how much of the cervical tissue is affected. LSIL changes seen on a Pap test are generally CIN 1. HSIL changes seen on a Pap test can be CIN 2, CIN2/3, or CIN 3.

Treatment for high-grade cervical cell changes

The goal of treating high-grade cervical cell changes is to remove or destroy abnormal cervical cells that have a high chance of becoming cancer. Some of these treatments are also used for early-stage cervical cancer.

The most common treatment for high-grade cervical cell changes is conization, the removal of a cone-shaped piece of tissue from the cervix and cervical canal. There are two types of conization.

Several other treatments may also be used.

Pregnancy and treatment for high-grade cervical cell changes

Rarely, procedures to treat cervical cell abnormalities can weaken the cervix, increasing the risk of premature birth or miscarriage.

If you are pregnant or plan to become pregnant, your health care provider will talk with you about procedures that are recommended for you and the timing of these procedures. Depending on your specific diagnosis, you may be treated postpartum, or after delivery.

For a downloadable booklet about cervical cancer screening, see Understanding Cervical Changes: A Health Guide.


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