The phone call I least like to make is the one a patient dreads the most: "Your Pap came back abnormal." I can almost hear the breath catch on the other end of the line. So let me say the thing I tell every woman first — an abnormal Pap smear is not a cancer diagnosis. It almost never is.
Most of the time, an abnormal result means a few cells looked a little off, often because of a common virus your body is likely to clear on its own. What it does mean is that we pay closer attention. In my practice, the abnormal Pap is the start of a conversation, not the end of one.
What does an abnormal Pap smear actually mean?
It means the cells we collected from your cervix didn't look completely typical under the microscope — not that something is wrong with you. Pap smears are a screening test, designed to flag tiny changes long before they could ever become a problem.
The most common result I see is called ASC-US, where a handful of cells are slightly unusual. We often pair that with HPV testing, since human papillomavirus drives the large majority of cervical changes. Plenty of healthy women carry HPV at some point and never know it. The point of screening is simply to catch the rare change that doesn't go away.
Should I worry if my result is abnormal?
No — but you should follow up, and that distinction matters. Worry tends to make people avoid the next step, and the next step is the whole game with cervical health.
Cervical cancer is one of the few cancers we can very often prevent outright, because the changes that lead to it move slowly and show up on a routine Pap smear first. Catching a change early gives us years of lead time. That's a luxury we don't get with most things in medicine.
What happens after an abnormal Pap smear?
It depends on what the result showed, and that's exactly why I sit down with each patient instead of sending a form letter. Generally, one of a few things comes next:
- We repeat the Pap in 6 to 12 months, since many mild changes resolve on their own.
- We add or review an HPV test to understand your risk more precisely.
- We refer you for a colposcopy — a closer look at the cervix with a lighted magnifier — if the result warrants it.
A colposcopy sounds scarier than it is. It's done in a gynecologist's office, takes a few minutes, and lets your specialist see anything the Pap flagged. As a Direct Primary Care physician credentialed at Cedars-Sinai, part of my job is making that referral smooth — getting you to the right doctor here in Los Angeles and making sure the results come back to me so nothing falls through the cracks.
How often should I get screened?
For most women, every three to five years is the right rhythm once your history is reassuring — though an abnormal result usually shortens that interval until we're confident things have settled. The exact schedule depends on your age, your past Paps, and your HPV status, which is something we sort out together rather than by a one-size chart.
I also use these visits to look at the bigger picture. A Pap appointment is a natural moment to check in on breast health and the rest of your preventative care — mammogram timing, vaccines, bone health, the routine things that are easy to let slide when life is busy.
The part patients forget
Here's what I wish more women knew: the result only protects you if you actually come back for the follow-up. I've seen abnormal Paps from years ago that were never rechecked, simply because life got loud and the reminder got buried. Part of what a small membership practice can do is keep that thread for you — a real person tracking the recheck, not an automated portal you have to chase.
If you've gotten an abnormal result and aren't sure what it means, or if you can't remember the last time you were screened, that's reason enough to reach out. I'd be glad to walk through your results with you, explain the next step in plain language, and make a plan that fits your life. Send me a message and we'll start there — calmly, and at your pace.