March 21, 2019

What Women (Don’t) Want: Abnormal Pap Smears

By Ellen Hearty, MD

women illustrationThe most common screening for cervical cancer is the Pap smear. The Pap smear uses a brush to lift cells from the outside of the cervix to identify early, precancerous cells in the cervix. Early intervention is the key to preventing cervical cancer from developing. The incidence and death rates of cervical cancer have decreased markedly since the Pap smear began, making it one of the most successful public health interventions of the past century.

Abnormal Results and Colposcopies

As a gynecologist, I see many patients who have abnormal Pap smear results. Depending on a person’s age, the severity of the Pap abnormality and the person’s history of Pap abnormalities, many of these women need to undergo a procedure called a colposcopy for further evaluation. A colposcopy includes a pelvic exam where the cervix can be inspected with a microscope to identify affected areas, and a biopsy can be taken from the cervix to allow the abnormality to be better defined. If the abnormality is confirmed to be severe, the woman undergoes a procedure to remove a larger portion of the cervix with the goal to remove all of the abnormal cells.

This regimen has led to the drastic reduction in development and death from cervical cancer. However, experiencing the procedure is stressful for women. It involves examining a very sensitive part of the body, and the biopsies and removals can cause pain. The time involved to obtain results can create a significant amount of anxiety for women. Furthermore, many women continue to have abnormal Pap smears over time and must undergo these procedures more than once. In order to protect patients in the long term, they must endure pain and stress in the short term.

Prevention with a Vaccine

Over the past several decades, the medical field has learned more about the role of the human papilloma virus (HPV) in causing Pap abnormalities and cervical cancer. Nearly all cases of cervical cancer are related to an HPV infection. In 2006, a vaccine was developed that can prevent HPV, thus protecting most women from abnormal Pap smears or cervical cancer. The HPV vaccine is also important to protect women from the many steps that occur to evaluate abnormal Pap smears. For many women who have struggled with abnormal Pap smears for years, the decision of whether to vaccinate their children against HPV is simple.

The CDC recommends all girls and boys who are 11 or 12 years old should receive the HPV vaccine, and that teen boys and girls who did not get vaccinated when they were younger should get it now. HPV vaccine is recommended for young women through age 26, and young men through age 21.

To learn more about the HPV vaccine for your child, read our recent blog post Making Decisions with Your Child Now to Help Protect against HPV Later.

Ellen Hearty, MD, is an OB/GYN at Mission Women’s Care. Dr. Hearty accepts patients in three convenient locations including Marion, Burnsville and Spruce Pine.

To find a women’s care provider in your area, visit