Updated November 19, 2025

Nobody loves getting a Pap test, also known as a Pap smear. The stirrups, the cold speculum, that feeling of total exposure — it ranks right up there with bathing suit shopping and root canals. Still, it’s essential. A regular Pap smear at your gynecologist’s office can detect abnormal cells that could lead to cervical cancer. 

The good news is that with a Pap test, abnormal cells can be treated before they progress to cancer.

The American College of Obstetricians and Gynecologists (ACOG) recommends the following:

• Women ages 21 to 29 should get a Pap test every three years.
• Women ages 30 to 65 should have a Pap test combined with an HPV test every five years.
• Some women with certain conditions may need more frequent testing, including women with a history of cervical cancer, HIV/AIDS or a weakened immune system.

What Happens After an Abnormal Pap Test?

If your Pap test results are abnormal, your doctor may recommend a colposcopy. If you’re told that you need a colposcopy, don’t panic. Most women do not have cancer when they come in for a colposcopy. 

The routine is similar to a Pap smear. But this time, your doctor will use a magnifying lens to look at your cervix in order to see abnormal cells. This is done by swiping the area with acetic acid, which turns abnormal areas white. Doctors may also use a digital colposcopy system called DYSIS to further pinpoint the exact location of changing cells. This makes diagnosis more precise.

During a colposcopy, your doctor may perform a biopsy, which involves taking a small amount of tissue for testing. You may feel a pinch when the biopsy is performed. Then, your cells are sent to a lab for analysis. You might experience mild cramping after the colposcopy, and can take pain medications such as ibuprofen or acetaminophen to help with discomfort.

What are the Treatment Options After an Abnormal Pap Test?

When your colposcopy is complete and your biopsy results are finalized, your doctor will explain the changes in your tissue sample. Low-grade changes mean you can watch and wait. Low-grade cervical changes are unlikely to become cervical cancer. 

If the changes are moderate to high grade, your doctor may recommend further procedures to remove the abnormal cells in order to decrease the risk of cervical cancer. Typically, your doctor will use the Loop Electrosurgical Excision Procedure (LEEP), or perform a cold knife cone biopsy as a minor surgical procedure to remove the abnormal, precancerous cells of the cervix.

Be sure to always bring up any questions you may have about your Pap test with your gynecologist.

Medically reviewed by Kimberly Levinson, M.D., M.P.H.