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What happens if my Pap smear is abnormal?

The next step is colposcopy and biopsies. Your doctor can find the actual abnormal areas of your cervix using colposcopy and remove them (biopsies) so that the pathologist can study them in detail. Colposcopy is just like a speculum exam, but instead of looking at your cervix with the naked eye, the doctor examines the cervix through a magnifying microscope. If dilute acetic acid (vinegar) is swabbed on the cervix, the abnormal areas are highlighted.

Your doctor will biopsy all the abnormal areas using a special instrument to remove small pieces of tissue from the cervix. Several biopsies are taken during a typical colposcopy. The abnormal cells seen on the Pap smear probably came from one or more of these areas. The pathologist can examine the tissue under a microscope to check for abnormal cells. Cervical dysplasia can range from very mild to a carcinoma in situ (CIS). In this condition, there are severely abnormal cells in the cervix.  CIS often leads to cervical cancer.