Patient Care

Is My Abnormal Pap Smear Cancer? What the Results Could Mean

Jan. 29, 2025
Alexandra Blackman

Cervical cancer screening is one of the best success stories in healthcare. Since the 1970s, the death rate from cervical cancer has dropped by more than half.

“The goal of the screening is to detect the cancer early, when it's easier to treat,” says Alexandra Blackman, MD, a gynecologic oncologist at Wilmot Cancer Institute who specializes in researching and treating cervical and other gynecological cancers.

The mortality rate continues to drop, thanks in part to the human papillomavirus (HPV) vaccine—which prevents the virus that causes most cervical cancers—and to routine screening.

The most common way to screen for cervical cancer today is either the Pap smear alone or a combination of the Pap smear and an HPV test. Here’s what you need to know.

What does cervical cancer screening entail today?

In a Pap smear, invented by George Papanicolaou, a medical professional uses a speculum to open the vagina, and a brush collects cells on the bottom part of the cervix.

A medical professional can look at the swab under a microscope and determine if these cells have signs of cervical cancer.

Is my abnormal Pap smear cancer?

An abnormal Pap smear does not necessarily mean you have cancer. If you have HPV, it also does not mean you have cancer or will definitely develop it. HPV causes most cases of cervical cancer, but it does not always cause it. Some women’s immune systems clear the infection before cancer develops. It often takes many years for an HPV infection to turn into cancer.

If your doctor finds that you have HPV, you will likely be followed more closely to ensure the HPV does not develop into cervical cancer.

Can a Pap smear detect HPV?

Medical teams can now also check for HPV when a woman is swabbed. This allows a potential cancer to be caught even earlier.

“Detecting an infection with a high-risk HPV virus is helpful because it can identify people who are at risk for developing cervical cancer early,” Blackman says. “These people can then be monitored closely, and any pre-cancerous cells can be identified and treated with simple procedures. Adding HPV testing to a traditional Pap smear increases the sensitivity of the screening.”

For most people, the immune system clears an HPV infection—often without the person even knowing they’ve had HPV. However, if the immune system is not able to clear the virus and it stays in the body, it can develop into cervical cancer over time. This development usually takes as long as 10 or 15 years.

Screening for uncleared HPV infection can help identify those who may be at higher risk of cervical cancer.

Pap smear results also tell us what subtype of HPV someone has, helping doctors determine if risk of cervical cancer is low or high. In some cases, further examination or even biopsy is necessary. Moving forward, women with HPV will likely have more frequent screenings to ensure the status doesn’t change.

Who should get cervical cancer screening?

As of December 2024, the guidelines state:

  • Women aged 21 to 29 should receive a Pap smear, where cells are removed and checked for abnormalities every three years. This is a process referred to as “cytology.”
  • Women aged 30 to 65 should be screened every three years with a Pap smear and every five years for HPV testing, or every five years with a combination cytology and HPV testing.

“Younger women are more likely to clear an HPV infection on their own than an older patient,” Blackman adds.

Do you need a Pap smear or cervical cancer screening if you are not sexually active?

Doctors still recommend it. While it is much less likely to have HPV if you are not sexually active, there is a small chance of getting HPV from other types of sexual interactions. There is also a very small chance HPV could have been transferred from the mother at birth. Patients always have the right to refuse a screening test.

If you are eligible for cervical cancer screening but do not have insurance, the Cancer Services Program of the Finger Lakes can help. Contact (585) 224-3070 or email csp@urmc.rochester.edu to learn more.

Can you get cervical cancer without HPV?

It is possible, but very unlikely. More than 90% of all cervical cancer cases are caused by HPV.

There are genetic syndromes, such as Peutz–Jeghers syndrome, that can increase a person’s risk of cervical cancer. But these are very rare.

Is cervical cancer hereditary?

Generally speaking, no. If your mom or a close family member had cervical cancer, it’s unlikely it could be “passed down” to you like some other cancers can be, because in most cases, cervical cancer is caused by HPV, a sexually transmitted infection.

However, sometimes things beyond your control can impact your risk of getting cervical cancer, such as issues with your immune system that make it harder for your body to clear the infection.


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