Ask an expert: What does an abnormal smear test result mean?

Receiving abnormal results following a smear test can understandably be concerning. However, as highly respected consultant obstetrician and gynaecologist Mr Hisham Abouzeid explains in this illuminating article, detecting abnormalities in this way is key in reducing the risk of cervical cancer. The leading specialist also offers expertly explains which are the next steps following an abnormal smear test result.

What do abnormal smear test results indicate?

A smear test can indicate whether your risk of developing cervical cancer is higher than that of the general population. If you get an abnormal result, further tests may be needed to double check your individual level of risk. Based on that, we will decide if any further management is required.

What is determined as an abnormal smear test result?

There are a range of abnormalities which can be identified with a smear test, some of which can later develop into cervical cancer. All of these abnormalities begin with a human papillomavirus (HPV) infection. The vast majority of HPV infections are resolved simply with natural immunity but a very small number of cases can progress into abnormal cells, which vary from mild to severe.

Less severe abnormalities are dealt with by the body’s immune system but the higher the grade of the abnormality, the more elevated the risk that it might develop into cervical cancer.

How common are abnormal smear test results? Should I be worried?

The vast majority of cases of abnormal smear test results end up showing no significant abnormality. In cases where we do find abnormal cells, there is usually an easy and quick way to eliminate the problem and very much reduce the individual’s risk of cervical cancer, especially when the abnormality is detected early.

Although the risk of cervical cancer in the general population is very small, our main aim is to try to reduce it as much as possible in the general population. In the UK, our cervical screening program has been responsible for a large drop in the number of cases of cervical cancer.

What are the next steps following an abnormal smear test?

If a woman’s smear test result has come back as abnormal showing a simple HPV abnormality with no abnormal cells, we usually repeat the smear one year later. If the second smear again shows human papillomavirus, the next step is to review the individual case in the colposcopy clinic. This is also necessary if abnormal cells are found during any smear test.

At the colposcopy clinic, we look at the cervix with magnifying equipment and apply some special stains on the cervix to identify if any abnormal cells are present. If the colposcopy shows no abnormality, then we can safely go back to performing a cervical smear every three years.

If the colposcopy shows an abnormality, we decide whether we should just keep an eye on it or if it should be treated. This action plan is based on the severity of the abnormality, as low grade cases may just need to be monitored, whereas high grade abnormalities are treated to reduce the risk of cervical cancer.

Treatment is safe and is usually relatively simple and quick. Patients usually spend only around ten to fifteen minutes undergoing their treatment at the colposcopy clinic and it is effective in significantly reducing their risk of cervical cancer.

If you are concerned about the results of a smear test or cervical cancer, don’t hesitate to reserve an appointment with Mr Abouzeid by visiting his Top Doctors profile.