An abnormal Pap test means the lab found cells on your cervix that look different from normal cervical cells. It does not mean you have cancer. In 2026, the vast majority of abnormal Pap results are mild changes that clear on their own or are treated easily in the office. Here is what those results usually mean and what the next steps look like at Complete Care ObGyn in Henderson.
Does an abnormal Pap mean that I have HPV?
Usually, but not always. Human papillomavirus (HPV) is by far the most common reason cervical cells change. It is a very common virus, and most sexually active adults are exposed to it at some point, often without ever knowing it. In most people, the immune system clears the virus within a year or two and the cervix returns to normal.
Certain “high-risk” types of HPV can linger, and over many years those persistent infections are what cause nearly all cervical cancers. That is exactly why your Pap is often paired with an HPV test after age 30. Knowing whether high-risk HPV is present tells your provider how closely to watch you. Our post on HPV and cervical health covers the virus in more detail.
What causes abnormal cervical cells besides HPV?
Not every abnormal result comes from a virus. Other things can make cells look irritated under a microscope, including:
- Vaginal infections such as yeast, bacterial vaginosis, or trichomoniasis
- Inflammation from recent sex, tampon use, douching, or having the test near your period
- Thinning of cervical tissue after menopause from lower estrogen
A urinary tract infection does not change cervical cells itself, but the irritation that comes with it can muddy the sample. When one of these causes is suspected, treating it and repeating the Pap is often all that is needed.
Low grade vs. high grade abnormal Pap test results
ASC-US means the cells are slightly unusual but the lab is not sure why. This is the most common abnormal result, and an HPV test usually decides whether more follow-up is needed. LSIL, or low grade changes, means mild cell changes that are almost always tied to a recent HPV infection and often go away on their own. HSIL, or high grade changes, are more likely to progress if left alone, so they are always evaluated further. A high grade result is still not a cancer diagnosis. It means precancerous cells may be present, and these are very treatable at this stage.
What do a colposcopy and biopsy involve?
If your results call for a closer look, your provider will schedule a colposcopy. It feels much like a regular Pap and takes about 10 to 15 minutes. A mild vinegar solution is applied to the cervix to highlight any abnormal areas, and a magnifying instrument called a colposcope, which stays outside your body, is used to examine them.
If an area looks concerning, a tiny sample of tissue is taken for biopsy. Most women feel a brief pinch, and light spotting or mild cramping for a day or two afterward is normal. Results usually come back within one to two weeks and show whether precancerous cells are present and how advanced they are.
Treatment for abnormal Pap test results
Many abnormal results need no treatment at all, just a repeat Pap or HPV test in six to 12 months to confirm the changes have cleared. This watchful approach is especially common for younger women and for low grade changes.
When precancerous cells do need to be removed, the most common option is a LEEP, which uses a thin electrical wire loop to remove the affected tissue in a short office procedure. Cryotherapy freezes the abnormal cells, and a cone biopsy removes a slightly larger cone-shaped piece of tissue when changes extend higher into the cervical canal. All of these preserve the uterus and are compatible with future pregnancy.
Can you have HPV but a normal Pap?
Yes, and it is common. A positive HPV test with a normal Pap simply means the virus is present but has not caused cell changes. Depending on the HPV type, your provider may repeat testing in a year or recommend a colposcopy sooner if a particularly high-risk type is found. It is a reason for follow-up, not alarm. We answered more of these questions in an earlier post on abnormal Pap smears and HPV.
Cervical cancer screening in Henderson
Cervical cancer is one of the most preventable cancers because it develops slowly and routine screening provides years of warning. The HPV vaccine adds another strong layer of protection through age 26, and some adults up to 45 also benefit. Screening intervals reflect current guidance and are adjusted over time, so if it has been more than three years since your last Pap or you are unsure when your next one is due, schedule an appointment at Complete Care ObGyn in Henderson. Our board-certified providers will review your results with you and explain all of your options.
