Abnormal Pap Test

British Columbia Specific Information

Cervical cancer occurs when abnormal cells in the cervix grow uncontrollably, forming tumors. It is the fourth most common cancer in women globally and one of the fastest-increasing cancers among females in Canada. However, it is preventable with HPV vaccination and regular screening.

HPV, a common virus, causes 99 per cent of cervical cancers, primarily types 16 and 18. In B.C., screening is recommended every 5 years for people with a cervix, including women and Two-Spirit, transgender and gender diverse (TTGD) people, aged between 25 to 69. You can choose self-screening by ordering a kit to self-screen or a Pap test performed by a health-care provider.

HPV screening every 5 years is as effective as a Pap test every 3 years. Self-screening is a convenient, effective option for detecting those at risk.

To learn more about the cervical cancer screening program in B.C., visit BC Cancer Agency - Get Screened. The HPV vaccines like Cervarix® (HPV2) and Gardasil® (HPV4), protect against HPV types causing most cervical cancers. Gardasil® (HPV4) is approved for everyone, while Cervarix® (HPV2) is approved only for women. Free vaccines are available for eligible groups and others can purchase them from a pharmacy or doctor's office. For information about the vaccine, including who is eligible to receive it for free, visit HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccine.

For more information about HPV and vaccine programs in B.C. visit,

Topic Overview

What is an abnormal Pap test?

A Pap test, or Pap smear, is done to look for changes in the cells of the cervix. If your test is abnormal, it means it found some cells on your cervix that don't look normal. Having an abnormal test doesn't mean you have cancer. The chances that you have cancer are very small.

What causes an abnormal Pap test?

Most abnormal Pap tests are caused by HPV infections. Other types of infection—such as those caused by bacteria, yeast, or protozoa (Trichomonas)—sometimes lead to minor changes on a Pap test called atypical squamous cells. Natural cell changes that may happen during and after menopause can also cause an abnormal Pap test.

What increases your risk for an abnormal Pap test?

Human papillomavirus (HPV) can raise your risk for having an abnormal Pap test. Certain sexual behaviours, like having sex without condoms and having more than one sex partner, can put you at risk for getting HPV. Smoking and having an impaired immune system can also increase your risk for having an abnormal Pap test.

Do abnormal cell changes cause symptoms?

HPV, which causes most cervical cell changes, usually doesn't cause symptoms. But some people with cell changes may have abnormal vaginal bleeding. This may include bleeding between periods, heavy periods, or bleeding after sex. If another vaginal condition is the cause, you may have other symptoms, such as vaginal pain, itching, or discharge.

What will you need to do if you have an abnormal Pap test?

You may need more tests to find out if you have an infection or to find out how severe the cell changes are. For example, you may need:

  • Colposcopy, a test to look at the vagina and cervix through a lighted magnifying tool.
  • An HPV test. Like a Pap test, an HPV test is done on a sample of cells taken from the cervix.
  • Another Pap or HPV test in about 6 to 12 months.

A colposcopy is usually done before any treatment is given. During a colposcopy, the doctor also may take a small sample of tissue from the cervix so that it can be looked at under a microscope. This is called a biopsy.

Treatment, if any, will depend on whether your abnormal cell changes are mild, moderate, or severe. In moderate to severe cases, you may have treatment to destroy or remove the abnormal cells.

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