Interpreting Cervical Biopsy Results: Insights into Pap Test Abnormalities and Precancerous Lesions

You may not know, but abnormal results in Pap smear tests are more common than you may think. Abnormalities in Pap smear tests can be of different types and each of them may need different treatment options. Some only need monitoring while others need further testing or treatment to manage. Learn about Pap test abnormalities and what you should expect in this article. Schedule an appointment at Doral Health and Wellness – Women’s Health Center.


Pap test abnormalities

When Pap smear tests detect abnormalities, it means that abnormal cells were detected in the sample and additional testing or treatment may be necessary. Treatment of abnormal cervical cells prevents the development of cervical cancer.

Cell types that are commonly found in Pap smear tests are squamous and glandular cells. Squamous cells are a type of cells that form the outer layer of the cervix. Abnormal changes in squamous cells are divided into several categories:

  1. Atypical squamous cells (ASC): These are the most common abnormalities found in Pap smear tests. These cells may be reported as atypical squamous cells of undetermined significance (ASC-H) or atypical squamous cells but can’t be excluded from the high-grade squamous intraepithelial lesion (ASC-H). Both results indicate that cervical cells are abnormal under the microscope, which means cell changes are unclear. A result of ASC-H indicates that cells may be at a higher risk of becoming cancerous compared to the result of ASC-US.
  2. Low-grade squamous intraepithelial lesions (LSIL): This is also called mild dysplasia, which means a Pap smear detects mild cell changes. A result in LSIL may not require treatment because the immune system often resolves these changes, especially in younger people.
  3. High-grade squamous intraepithelial lesions (HSIL): It’s also known as moderate or severe dysplasia, which means a Pap smear detects somewhat to very abnormal cell changes. These changes can put you at risk of cancer if left untreated.
  4. Carcinoma in Situ (CIS): A result of CIS indicates that more severe cell changes are detected during the Pap smear test. These changes appear similar to cervical cancer but don’t spread beyond the surface of the cervix. These cells are more likely to progress into cancer if left untreated.


  1. Squamous cell carcinoma: This is a type of cervical cancer, although it’s very rare for patients to be detected for squamous cell carcinoma who receive regular cervical cancer screening. This result indicates that abnormal squamous cells have spread deeply into the cervix and other parts of the body. Glandular cells are found in the tissue that forms the inner portion of the cervix. Abnormal cell changes in glandular cells are divided into these categories:
  2. Atypical glandular cells (AGC): A result of AGC means that abnormal glandular cells were detected under the microscope in the Pap smear test. This means abnormal cell changes are unclear.
  3. Endocervical adenocarcinoma in situ (AIS): If a Pap smear test detects AIS, it means that more severe cell changes were found but not yet spread beyond the glandular tissue of the cervix.
  4. Adenocarcinoma: This is a type of cervical cancer that starts in glandular cells and can spread deeper into the cervix or to other parts of the body. While it is very rarely found in Pap tests in patients who take regular screening for cervical cancer. It required immediate treatment if detected.


In addition to cell changes in squamous and glandular tissue, a Pap smear test can also detect other kinds of abnormalities, which include:

  • Endometrial cells: A Pap smear may detect endometrial cells, which are cells formed in the lining of the uterus. These cells may be present in healthy individuals during menstruation; however, they should not be prevented in a cervical sample after menopause. This finding can be normal in young patients, but if Pap smear results for patients 45 or older show endometrial cells, then it needs medical attention.
  • Other types of cancer: While finding other types of cancer is never a goal of a Pap smear test, sometimes the test can detect cancerous cells that are not related to cervical cancer. A Pap smear may detect cancerous cells from the fallopian tubes, ovaries, endometrium, peritoneum, vulva, or vagina.
  • Infection or inflammation: A Pap test may also detect some infections and inflammation of the cervix.


What happens next?

If your test results are normal, no abnormal cell changes are found. Then, you don’t need any treatment or screening. Just make sure to follow regular cervical screening on your next appointment.

In contrast, if abnormal Pap cells are detected, the doctor may recommend further testing or treatment options depending on individual factors like your age, whether you’re menopausal or not, or whether HPV was or wasn’t detected. If it isn’t serious, a follow-up Pap smear test within 1 year is recommended to check for further changes. If a vaginal infection is detected, the doctor may give treatment for the infection. If abnormal cells are detected, the doctor may recommend a colposcopy with a biopsy to make a firm diagnosis to detect the underlying cause of the abnormality and to create a treatment plan accordingly.


Cervical biopsy results often come from pap smear test results, as this is the primary test used to detect abnormalities in the cervix. While it’s not always 100% accurate, it gives great insights into cervical cell abnormalities and also picks up some other types of abnormalities. If a Pap smear produces unsatisfactory results due to any reason, then this test will be repeated to get proper results this time. If your test results are normal, you don’t need further testing now until your regular cervical cancer screening appointment comes. In case your test results detect abnormalities, then the doctor may order further testing or treatment depending on different factors to cure or manage those abnormalities on time.


Need help with cervical biopsy, visit our gynecology clinic in Brooklyn to get professional diagnosis and treatment facilities that ensure you get better and live a better life. Call us to book your appointment now! At Doral Health and Wellness – Women’s Health Center, we have the best GYN doctor in Brooklyn, and we provide women with quality health care services. To schedule an appointment, you can visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call us on 1-347-384-5690. You can also visit our website at