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Abnormal Pap Smear

The Pap screen and human papilloma virus (HPV) screen are often performed together to check for the earliest changes in your cervix that, if left without attention, can lead to cancer. The frequency of screening is determined by age, previous results, and conditions that create a weakened immune system.

The Pap and HPV screen may show abnormal and precancerous cells of the cervix or may indicate the presence of high-risk HPV. Either indicate abnormal test results.

The screening results, your medical history, and findings on your pelvic examination will direct your next steps in care. This could mean simply returning in six months for a follow-up Pap test. If the results are more concerning, then a colposcopy is the next step.


The colposcopy is performed in the office and involves visualizing the cervix with a magnifying viewer to assess for small changes of the cervix. This is enhanced by washing the cervix with simple vinegar and manipulating of the color of the light. During the colposcopy, possible abnormalities are sampled (cervical biopsies). Further sampling of the canal of the cervix is sometimes taken − this is called an ECC or an endocervical curettage. An ECC is used to check if the abnormality has extended into the canal of the cervix and cannot be seen to assess.

Based on the results, the cervix may simply be observed with a follow-up test. At times, further therapy is taken. Different types of outpatient surgeries can remove an abnormal surface sample of the cervix with or without an extension into the canal of the cervix. You and your doctor would discuss this plan if needed.

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