Pearl obstetrics | gynaecology

Abnormal smear

  • PAP smear test
    PAP smear
    If you have an abnormal smear, give us a call for an appointment.

Abnormal smear (CST) | Cervical Screening Test | Glengarry Hospital | Perth

Getting an abnormal smear (now called the CST) result is worrying. The first message is that it is very rare to have a cancer, so don’t panic. The smear is designed to show high risk HPV and/or pre-cancerous cells. This allows assessment and treatment before cancer of the cervix develops (cancer would usually only develop many years later). If you give us a call here, we’ll prioritise your appointment and see you as soon as possible – setting your mind at ease.

High risk HPV on a smear

If the smear detects high risk HPV, a colposcopy is needed to see if there are any abnormal cells present, and where they are. Abnormal cells won’t necessarily be seen at all, but if they are they could be low grade or high grade.

Intermediate risk HPV on the CST

If this is detected, the usual plan is to repeat the CST in a year. If it was still present colposcopy is advised.

Low grade abnormalities on a smear

HPV and/or low grade abnormal smears can often settle on their own with time. It is common to simply repeat a CST in 12 months with a low grade abnormal smear. Often the CST will change back to normal. If you smoke, stopping can help your body change the abnormal smear back to normal more easily.

However, low grade changes can persist. Also, high grade change can be present and only show on the smear as low grade – in other words, the abnormality is more severe than the smear is indicating. This happens in about 20% of women in Perth with persistent low-grade smears. This is why women are advised to have a colposcopy – to make sure there isn’t any high-grade change. Any high-grade change found is more likely to develop into cancer of the cervix over the years, so we remove it.

High grade abnormal cells on a smear

When high grade abnormal cell changes are seen on the smear, immediate colposcopy is needed. We will see you quickly if you call us with this result on your smear. Colposcopy allows us to see how many abnormal cells there are, where they are, and how we should treat the area that has the abnormal cells. Small biopsies may be taken for further assessment. Often, a decision is made to remove the entire affected area.

How effective is treatment of abnormal cells on the cervix?

Fortunately, the vast majority of abnormalities of the cervix can be assessed with colposcopy & be treated easily. This prevents many future incidences of cancer of the cervix. Occasionally (in approx 1% of women with high grade cells) an invasive cancer is found by the lab after treatment and further surgery is needed, for example, a cone biopsy, hysterectomy or radical hysterectomy and removal of glandular tissue. This is rare.


First of all, we do a colposcopy examination to assess the changes on the cervix directly. This is bit like a smear test, but takes longer. Biopsies may be needed. We decide whether we need to remove the abnormal cells, or whether the changes are mild and your abnormal smear is likely to get better on its own. Sometimes we need to wait for results before we can make this decision. See the colposcopy page for more information.

Treatment of pre-cancerous cells on the cervix

If treatment is needed, as we think there is a possibility of high-grade changes, we remove the abnormal cells by performing a LLETZ procedure. Most women have this done under local anaesthesia but some women prefer to go to sleep with a general anaesthetic – either is fine. 4-6 months after a LLETZ, we look again with the colposcope and do another smear/CST just to check all is OK.

It’s important not to sit at home worrying about an abnormal smear. Assessment & treatment is straightforward, routine and will put your mind at ease. Give us a call and make an appointment.

Have you had an Abnormal Smear

Most abnormal smears are easily sorted. Get peace of mind, and give us a call to make an appointment.

PEARL obstetrics | gynaecology

Our office is situated near Glengarry Private Hospital in Perth. We provide easy free parking. We're easily accessible from Joondalup, Hillarys, Stirling, Currambine, Ocean Reef, Beldon, Connolly, Edgewater, Wanneroo, Burns Beach, Sorrento, Padbury, Marmion, Watermans Bay, North Beach, Karrinyup, Gwelup, Carine, Balcatta, Westminster, Mirrabooka, Malaga, Hamersley, Koondoola, Girrawheen, Marangaroo, Greenwood, Warwick, Madeley, Darch, Wangara, Kallaroo, Craigie, Heathridge, Woodvale, Scarborough, Doubleview, Innaloo, Osbourne Park, Wembley Downs, Tuart Hill, Trigg, North Beach. The Western suburbs (Cottesloe, Claremont, City Beach, Floreat, Swanbourne) are all within easy reach.