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What is an abnormal Pap?

The Pap test was originally designed as a screen test to identify women who felt fine physically, but were actually at risk of developing cervical cancer. Physicians examined the cell sample for dysplasia (precancerous lesions or cancer), but could not check for the human papillomavirus (HPV), which is almost always the cause of cervical cancer. This used to lead to a high number of inaccurate, false positive results.

Today, gynecologists combine the results of the Pap test with genetic testing for the presence of the HPV, which has greatly reduced the number of unnecessary false positive results. If you receive abnormal Pap results, our specialists will know if it is simply a false positive that can be monitored conservatively, or if there is a high-risk HPV infection present that requires additional testing.

Our approach

If your Pap test results came back abnormal, you are probably feeling anxious about what to do next. That’s why Northwell Health gynecologists will immediately explain the results and order the proper additional tests to find out if any action must be taken.

If precancerous lesions are found, you may be referred to Northwell Health’s Gynecologic Oncology Center. Here, you will have access to physicians who are involved in leading-edge programs in the prevention of cervical cancer through regular screenings.

If you do need cervical cancer treatment, you will be cared for by a team of specialists across a variety of disciplines all working together to create an individualized treatment plan that best fulfills your needs.

Risk factors

The vast majority of abnormal Pap tests are caused by a high-risk HPV infection, but a handful of factors can increase the chances of receiving abnormal results, including:

  • Having multiple sexual partners
  • Smoking
  • Medications that suppress your immune system, such as chemotherapy or steroids
  • HIV or AIDS
  • A previous abnormal Pap test

Of all risk factors, the biggest one is not going to your doctor. Most women diagnosed with advanced cervical cancers have not seen a gynecologist in over 10 years. It is crucial that you get a Pap test every few years as recommended by our doctors. If you receive abnormal results, your gynecologist can immediately begin preventive treatment, which can greatly reduce your chance of developing cervical cancer.


In many cases, symptoms associated with cervical cancer don’t appear until the disease is in later stages. A Pap test can expose cervical cancer at a highly treatable stage before symptoms are present, which is another reason to have regular Pap tests.

If symptoms are present, the most common ones associated with cervical cancer include:

  • Irregular vaginal bleeding
  • Bleeding after sexual intercourse
  • Pain during intercourse
  • Abnormal vaginal discharge
  • Bleeding after menopause
  • Pelvic, back or leg pain
  • Weight loss

What a diagnosis means

The Pap test can only be used for screening purposes. If your results are abnormal, additional testing may be necessary for a diagnosis. Depending on your results, your gynecologist may recommend careful monitoring with regular Pap tests. In other cases, a biopsy or colposcopy may be needed to more closely examine the abnormal tissue. Unlike a Pap test, the biopsy and colposcopy are diagnostic tests and can result in definitive answers.

Treatment options

Your gynecologist will develop an individualized treatment plan depending on the reason for your abnormal Pap results. Treatments can range from careful monitoring to surgery.

The most common treatments for abnormal Pap test results include:

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