Understanding an Abnormal Cervical Screening Result: What It Means and What Happens Next

Getting a letter or a call to say your Cervical Screening Test was abnormal can be frightening, and it is natural to jump straight to the worst possibility. The most important thing to know is this: an abnormal result rarely means cancer. For most women it means the test has done exactly what it is designed to do, picking up something early so it can be watched or treated long before it ever becomes a problem.

This guide explains what an abnormal result actually means, what a colposcopy involves, and what happens at each step, so you can walk into your appointment informed rather than anxious.

What the Cervical Screening Test Looks For

In Australia, the Cervical Screening Test replaced the Pap smear in 2017. Instead of looking first for abnormal cells, it looks for human papillomavirus (HPV), the common virus responsible for almost all cervical cancers. If HPV is found, the same sample is then checked for cell changes.

A few facts that put results in perspective:

• HPV is extremely common. Most people who have ever been sexually active will come into contact with it at some point.

• In the large majority of people, the immune system clears HPV on its own within a year or two, with no lasting effect.

• Only persistent infection with certain high-risk types, over years, can lead to the cell changes that matter.

Screening is recommended every five years for women and people with a cervix aged 25 to 74. You can have the sample taken by your doctor or nurse, or collect it yourself with a simple vaginal swab, an option now available to everyone eligible.

What "Abnormal" Actually Means

An abnormal result usually falls into one of a few categories. Understanding which one applies to you takes most of the fear out of the word.

HPV not detected. This is a normal result. You return to routine screening in five years.

HPV detected (types other than 16 and 18). These are high-risk types, but lower risk than 16 and 18. The lab automatically checks the same sample for cell changes. If there are none, or only minor ones, the usual next step is a repeat test in twelve months to see whether your body has cleared the virus, which most people do. If more significant cell changes are found, you are referred for a colposcopy.

HPV 16 or 18 detected. These two types cause the majority of cervical cancers, so a colposcopy is recommended straight away, whether or not cell changes are seen. This is caution, not alarm. It simply means a closer look is the safest next step.

Some women are referred for colposcopy a little sooner than others, based on screening history or individual risk factors. Your doctor will explain where you sit and why.

What Is a Colposcopy?

A colposcopy is a closer look at the cervix using a colposcope, a magnifying instrument with a light. The colposcope stays outside your body, and the examination itself is very similar to having a screening test.

What to expect:

• You lie in the same position as for a screening test, and a speculum is used to see the cervix.

• A vinegar-like solution is applied, which makes any abnormal areas show up more clearly. It may sting slightly but is not painful.

• If an area looks abnormal, a small tissue sample (biopsy) may be taken and sent to the lab. This can feel like a brief pinch or a period-type cramp.

• The whole appointment usually takes around fifteen to twenty minutes.

Afterwards you can go straight back to your day. If a biopsy was taken, some light spotting or mild cramping for a day or two is normal.

If Abnormal Cells Are Confirmed

If a biopsy confirms precancerous cell changes, it is worth pausing on that word. Precancerous is not cancer. It means cells that could, if left alone over many years, eventually develop into cancer. Treating them now removes that risk almost entirely.

The most common treatment is a LLETZ (large loop excision of the transformation zone), a short procedure that removes the affected area of the cervix using a fine heated wire loop, usually under local anaesthetic. It is quick, highly effective, and generally very well tolerated. Not everyone needs treatment. Sometimes the right course is simply to monitor changes that are likely to resolve on their own.

Whatever the finding, it will be explained clearly, along with what it means for you and what your options are.

Why This System Works

Cervical cancer is now one of the most preventable cancers there is, because we can find and treat the changes that precede it. Two things make that possible: regular screening, and the HPV vaccine.

The HPV vaccine (Gardasil 9) is given through the school program and protects against nine types of HPV, including 16 and 18. Since 2023 it has been a single dose for most young people, with free catch-up available up to age 25. Vaccination does not remove the need for screening, because it does not cover every high-risk type, but the two together are what make eliminating cervical cancer a realistic goal in Australia.

If you have had an abnormal result, the takeaway is not that something has gone wrong. It is that the system is working exactly as intended.

Meet Dr Scott Walker: Gynaecologist and Certified Colposcopist

Dr Scott Walker is an experienced gynaecologist and certified colposcopist who assesses and manages abnormal cervical screening results. He provides calm, clear, patient-centred care at what can be an anxious time, taking the time to explain your result, what he sees at colposcopy, and what he recommends.

Alongside colposcopy, Dr Walker manages the full range of gynaecological conditions, with particular expertise in pelvic pain, endometriosis and adenomyosis, and advanced laparoscopic and hysteroscopic surgery. As Vulval Disorders Lead, he also cares for conditions such as vulvodynia, lichen sclerosus, and abnormal vulval cells.

What to Expect at Your Appointment

• Listening first: your history, your questions, and any worries about the result or the procedure.

• A clear explanation: what your result means and why a colposcopy has been recommended.

• Gentle, unhurried care: the examination explained at each step, with your comfort the priority.

• A plan: whether that is reassurance and a return to routine screening, a repeat test down the track, or treatment, you will leave knowing what happens next and when.

  
  

Our Care Philosophy

• Evidence-based: care follows the National Cervical Screening Program Guidelines.

• Reassuring: clear information at every step, so you understand your result rather than fear it.

• Respectful: your comfort and your questions come first.

  
  

Ready to Take the Next Step?

If you have had an abnormal cervical screening result, or you would like a colposcopy assessment, book a consultation with Dr Scott Walker. Please bring your screening result and any earlier results if you have them.

An abnormal result is common, it is manageable, and it is exactly the kind of thing early assessment is designed to catch.

Helpful, Trusted Resources

• National Cervical Screening Program (Australian Government Department of Health)

• Cancer Council Australia: cervical screening information

• Australian Centre for the Prevention of Cervical Cancer (ACPCC)

  
  

Disclaimer

This article provides general information and does not replace medical advice. Please seek personalised guidance from a qualified healthcare professional. Guidelines are regularly updated, and our practice keeps recommendations current.