What are abnormal smear tests?

Regular cervical screening is one of the most important ways to look after your gynaecological health. A smear test checks for human papillomavirus (HPV) and for changes in the cells of the cervix that could, over time, lead to cancer. Early-stage cervical cancer usually has no symptoms, which makes screening so valuable. If you have been told you have an abnormal smear, it is natural to worry, but an abnormal smear rarely means cancer.

What does an abnormal smear mean?

Smear test results come back as normal, unclear or abnormal. An abnormal smear means your sample contained HPV, abnormal cells, or both. It does not mean you have cervical cancer. In most cases, it means there are early changes that need a closer look, monitoring or simple treatment. The best way to stay protected is to attend every screening appointment you are invited to; our smear tests and cervical screening page explains how it works.

What causes an abnormal smear?

Understanding the causes of an abnormal smear can help you know what to expect and what action to take.

• Human papillomavirus (HPV): HPV is a very common infection, passed on through sexual contact, and it is the leading cause of cervical cancer. It usually causes no symptoms, and most of the time the body clears it by itself. However, some high-risk types can persist and lead to precancerous changes, which is why monitoring matters.
• Cervical dysplasia: this means abnormal changes in the cells of the cervix. It is closely linked to HPV and is most common in women under 30. Mild changes often settle without treatment, with careful follow-up. Changes that persist for more than two years usually need treatment to remove the abnormal cells.
• Cervical cancer: occasionally, an abnormal smear leads to a diagnosis of cervical cancer. Because it develops slowly, finding changes early means they can be removed before cancer ever forms.
• Infections: some sexually transmitted infections, such as herpes or gonorrhoea, and other infections like thrush can affect your result.
• Other harmless causes: recent sex, lubricant, tampons, powders or sprays, a period, pregnancy, or occasionally a laboratory error.

What happens after an abnormal smear?

If your result shows changes, you may be offered a colposcopy. During this simple procedure, Mr Jafaru Abu uses a type of microscope to look closely at the cervix, vagina and vulva for signs of disease. Sometimes he takes a small sample of tissue (a biopsy) for further testing.

A colposcopy takes around 20 minutes and is usually not painful. After a biopsy, some women have light bleeding, discharge or mild discomfort for up to two days. Results are usually back within one to two weeks, and Mr Abu will explain what they mean and whether any treatment is needed.

Looking after yourself after an abnormal smear

A positive HPV result does not mean your partner has been unfaithful; the virus can stay silent for many years. Even so, it can help to talk openly with a partner about your result. Stopping smoking also helps your body clear HPV.

See a doctor between screenings if you notice symptoms such as bleeding between periods, bleeding after sex or unusual discharge.

Cancer Research UK explains what cervical screening results mean, and the World Health Organization describes how HPV leads to cervical cancer. You can read more on our abnormal cervical smears page. If you would like advice about an abnormal smear or a private colposcopy, you can book an appointment with Mr Jafaru Abu at The Park Hospital, Nottingham.