What does an abnormal Pap smear mean?
A Pap smear (Pap test) collects cells from the cervix, the neck of the womb, and checks them for changes. An abnormal result means some cells look different. These changes are graded from mild to more significant. Mild changes are very common and often return to normal by themselves, especially in younger women.
What do the terms on my result mean?
- ASC-US: slightly unusual cells of uncertain meaning. Often linked to HPV or inflammation.
- LSIL (low-grade): mild changes, usually caused by HPV, which often clear on their own.
- HSIL (high-grade): more significant changes that need a colposcopy and may need treatment.
- AGC: unusual glandular cells, which need further assessment.
What does HPV have to do with it?
Almost all cervical cell changes are caused by persistent infection with high-risk types of human papillomavirus (HPV), a very common virus. Most HPV infections clear within one to two years. When the virus persists, it can cause changes that may, over several years, develop into cervical cancer if they are not found and treated. This is why regular screening matters.
What happens next?
Your doctor will recommend one of the following, based on your age, your result and your HPV status:
- A repeat test after an interval, for mild changes.
- An HPV test to see whether high-risk HPV is present.
- A colposcopy: the cervix is examined through a magnifying instrument, a mild solution highlights any abnormal areas, and a small sample (biopsy) may be taken. It takes about 10 to 15 minutes and feels similar to a Pap smear, with a brief pinch if a biopsy is taken.
- Treatment for high-grade changes, usually a short procedure that removes the abnormal area so healthy tissue can grow back.
What if I am pregnant?
A colposcopy is safe during pregnancy. If treatment is needed, it is usually planned for after your baby is born, with close monitoring in the meantime.
How often should I be screened in Singapore?
Singapore's national guidance for women who have ever been sexually active is a Pap test every 3 years from age 25 to 29, and an HPV test every 5 years from age 30 to 69. After an abnormal result, you may need more frequent tests for a while.
This article is general information and does not replace a consultation with a doctor. If you are worried about your health, please book a visit or, in an emergency, call +65 6535 8833.
