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What Is An Abnormal Smear Test

Updated: Sep 20, 2023


If you've recently received an abnormal smear test result, you're likely filled with many questions and concerns. Understandably, the term "abnormal" can evoke a sense of fear and uncertainty. However, it's crucial to remember that an abnormal result is NOT a cervical cancer diagnosis but rather a signal for further investigation.

For personalised care and a thorough evaluation, consider booking an appointment with Rylon Clinic, a leading gynaecology clinic in London renowned for its multidisciplinary approach and state-of-the-art diagnostic technologies.

This comprehensive guide aims to demystify the complexities surrounding abnormal smear tests, providing professional, evidence-based advice on interpreting results, understanding risk factors, and exploring treatment options.

Understanding Smear Tests

What is a Smear Test?

A smear test, more formally known as cervical screening, is a preventative medical test designed to detect abnormal cells in the cervix before they have the chance to develop into cervical cancer. A healthcare professional conducts the test by collecting a sample of cells from the cervical canal using a specialised brush or spatula. This sample is then sent to a laboratory where it undergoes microscopic examination to identify changes in cervical tissue, including squamous and glandular cell abnormalities.

Why is it Important?

The importance of cervical screenings cannot be overstated, especially for women aged 25 to 64. In Northern Ireland and other parts of the UK, it's recommended that women in this age group undergo this screening every 3-5 years. Regular smear tests serve as a critical line of defence in women's healthcare, enabling the early identification of abnormal cells, including high-grade cervical cell changes and precancerous cells.

Timely detection allows for immediate intervention, significantly reducing the risk of these cells progressing to cervical cancer. Furthermore, smear tests can identify other conditions, such as infections and inflammatory cell changes, providing a comprehensive overview of cervical health.

By adhering to regular screening schedules, women can take an active role in their healthcare, making informed decisions based on accurate, timely information. The test itself is quick, usually taking no more than a few minutes, but its impact on your long-term health can be profound. Therefore, it's essential to prioritise this simple yet crucial procedure in your healthcare routine.

What Does an "Abnormal" Result Mean?

Decoding the Term "Abnormal"

An "abnormal" smear test result can be a source of significant anxiety and concern. However, it's crucial to understand that an abnormal result is not an immediate cause for alarm, nor is it synonymous with a cervical cancer diagnosis. Instead, an abnormal result serves as an indicator that there are cell changes in the cervical tissue that require further investigation.

These changes can range from minor alterations, often caused by infections or inflammation, to more significant changes that could be precursors to cervical cancer. In many cases, these abnormal cells resolve independently without any medical intervention. However, in some instances, they may require treatment to prevent them progressing to cervical cancer.

Types of Abnormalities

Abnormal results can be categorised into several types, including squamous cell abnormalities and glandular cell abnormalities. Squamous cell abnormalities are changes in the flat cells covering the surface of the cervix. These can range from low-grade changes, which are generally not a cause for concern, to high-grade changes that may require immediate medical attention.

Glandular cell abnormalities, on the other hand, affect the mucus-producing cells lining the cervical canal. These abnormalities are less common but can be more challenging to treat. Both types of abnormalities can vary in severity and may require different diagnostic procedures and treatments, such as a biopsy to take a piece of tissue for further examination or a wire loop procedure to remove abnormal tissue.

The Screening Results Letter

After a smear test, you will receive a screening results letter that outlines the findings. This letter can be confusing and filled with medical jargon. It's essential to consult with a healthcare provider to understand the implications of the results fully. The letter may recommend further tests, such as a colposcopy, where a special microscope is used to examine the cervix or additional tissue samples may be taken for a more detailed analysis.

The Connection Between HPV and Abnormal Smear Tests

What is Human Papillomavirus (HPV)?

Human Papillomavirus, commonly known as HPV, is a group of related viruses that can infect the genital areas, mouth, and throat. There are more than 200 types of HPV, of which at least 14 are considered high-risk for leading to cervical cancer. High-risk HPV types are particularly concerning as they are more likely to cause cell changes that can progress to cervical cancer.

It's worth noting that HPV is incredibly common; most sexually active individuals contract at least one type of HPV during their lifetime. However, the body's immune system clears most HPV infections within two years.

HPV and Abnormal Results

There is a strong correlation between high-risk HPV and abnormal smear test results. In many healthcare settings, HPV testing is often conducted alongside smear tests to provide a more comprehensive understanding of a woman's cervical health. If high-risk HPV is detected, additional tests and treatments may be recommended to address the abnormal cells and mitigate the risk of developing cervical cancer. These may include a repeat smear test, a colposcopy, or even surgical procedures to remove the affected tissue. Following the recommended treatment plan is crucial to ensure the best possible outcome.

Risk Factors for Abnormal Smear Tests

Understanding Risk Factors

Understanding the risk factors associated with abnormal smear tests can empower women to proactively manage their health. While some risk factors are beyond one's control, such as age and genetics, others can be managed through lifestyle changes and regular screenings.

Age and Gender

Women aged 25 to 64 are most commonly advised to undergo regular smear tests. The frequency of these tests may vary based on age and previous test results. It's worth noting that the risk of cervical cell abnormalities increases with age, making regular screenings crucial for early detection and treatment.

Lifestyle Choices

Factors such as smoking, a poor diet, and a lack of regular exercise can increase the risk of abnormal smear test results. These lifestyle choices can weaken the immune system, making it more challenging for the body to fight off infections like HPV, which can lead to abnormal cell changes.

Genetic Predisposition

While most cases of cervical cancer are not hereditary, a family history of the disease can increase your risk. If cervical cancer or precancerous cell changes have been diagnosed in close family members, discussing this with your healthcare provider is advisable.

What Happens After an Abnormal Smear Test?

The Follow-Up Process

Receiving an abnormal smear test result can be alarming, but it's important to remember that this is often the first step in a series of diagnostic procedures. Your healthcare provider will typically recommend additional tests to determine the nature and extent of the abnormal cells. These may include a colposcopy, where a special microscope is used to examine the cervix, or a biopsy to take a tissue sample for further examination.

Treatment Options

Based on the results of these additional tests, a range of treatment options may be considered. These could include watchful waiting for low-risk abnormalities, medication for infections, or surgical procedures like a wire loop excision or cold probe cryotherapy to remove abnormal tissue.

Common Treatments for Abnormal Results

Watchful Waiting

A "watchful waiting" approach may be recommended for low-grade abnormalities that are not immediately concerning. This involves regular monitoring through follow-up smear tests to track any changes in the cervical cells.

Medication and Topical Treatments

In cases where an infection causes the abnormal cells, medication such as antibiotics or antiviral drugs may be prescribed. Topical treatments may also be used to treat minor abnormalities.

Surgical Procedures

For high-grade abnormalities, surgical procedures may be necessary. These can range from a wire loop excision, which uses a fine wire loop to remove abnormal tissue, to more invasive procedures like a hysterectomy in extreme cases.

The Importance of Early Detection

Preventing Cervical Cancer

Early detection is crucial in preventing the progression of abnormal cells to cervical cancer. Regular smear tests and HPV screenings can identify high-risk factors and abnormalities in their earliest stages, allowing for timely intervention.

High-Grade Cervical Cell Changes and Precancerous Cells

Identifying high-grade cervical and precancerous cell changes early can significantly improve the prognosis and reduce the need for aggressive treatments. This is why adhering to regular screening schedules and following any recommended treatment plans is crucial.


This comprehensive guide aims to provide you with a thorough understanding of abnormal smear tests, from what they are and why they are essential to interpreting results and understanding treatment options. Remember, an abnormal result is not a cause for immediate alarm but rather a signal for further investigation.

If you've recently received an abnormal smear test result or are due for cervical screening, don't delay in taking the next steps. For personalised, expert advice and state-of-the-art diagnostic procedures, consider booking an appointment at Rylon Clinic. Your health is your most valuable asset; take proactive steps to protect it today.

Author: Mr Osama Naji

Mr Naji offers a “one-stop” gynaecology clinic for instant detection of various gynaecological cancers as well as providing all the diagnostic and treatment services needed under one roof.

Mr Naji provides advanced gynaecology scanning which is essential when conducting any gynaecology consultation, he is bilingual in English and Arabic and has an NHS base at the highly reputable Guy's and St Thomas' Hospital in London.

He is passionate about raising awareness of various subtle signs and symptoms of gynaecological conditions that are often overlooked by patients.

You can read more about Mr Naji on his about page here.


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