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1. What happens next?

Further Pap smears

If your Pap smear shows you have a definite or possible low grade abnormality, your doctor will usually recommend a repeat Pap smear in 12 months time. This is because HPV is the cause of almost all abnormal results, and it usually clears up in one to two years. Pap smears make it possible to check that this has happened.

If you are 30 years of age or more and do not have a history of normal Pap smears over the past two or three years, your doctor will recommend either a repeat Pap smear within six months, or a colposcopy now. You can discuss these options with your doctor, nurse or health worker and decide which is best for you.

You may be wondering why there is a slight difference in the recommendation for some women over 30 years of age. This is because it is more likely that an ‘older’ woman may have a persistent or ongoing infection with HPV and have a slightly higher risk of having a high grade abnormality, even though the Pap smear suggests a low grade change.

Women over 30 years of age who have had regular normal Pap smears can be reassured that they do not have a persistent HPV infection, so it is quite safe for them to have a repeat Pap smear in 12 months. For women who have not had the reassurance of a normal smear in the past two to three years, it is safer to have an early repeat smear or a colposcopy.

If your Pap smear shows you have a definite or possible low grade abnormality, the most likely outcome is that your doctor will recommend a repeat Pap smear in 12 months time.

The following diagram shows the usual recommendations for managing low grade abnormal Pap smear results.


If your Pap smear report shows you have a low grade abnormality and you have had previous Pap smears that have been normal, you can simply have another Pap smear in 12 months time.

A repeat Pap smear in 12 months is safe. Most cancers of the cervix take up to 10 years to develop.

If this is your second consecutive low grade Pap smear result, your doctor will refer you for a colposcopy.

If the colposcopy shows everything is normal, your doctor will suggest you have Pap smears yearly until you have two normal results in a row. After this, you can return to the usual time of every two years for your Pap smear. The same applies if the colposcopy shows that you have a low grade abnormality.

If there is any evidence of a high grade abnormality during the colposcopy, a biopsy will probably be done to check this.

There is no need to have treatment for low grade abnormalities.

Treatment is not recommended because these changes are now known to be a result of HPV infection, which is likely to clear up on its own.

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