Abnormal cells seen on a Pap smear range from mild to severe, and do not necessarily mean that you have cervical cancer.
Atypical cells, the mildest kind of abnormality, are often caused by simple infections or inflammation. Sometimes they are caused by precancerous conditions that could one day turn into cancer, and start growing into nearby tissue or spreading to other parts of the body.
Cervical intraepithelial neoplasia is one such precancerous condition that can show up on a Pap smear. Low-grade cervical intraepithelial neoplasia is less likely to turn into cancer. The presence of these cells on a Pap smear result is called a low-grade squamous intraepithelial lesion. You and your doctor should keep a close eye on it, such as by scheduling a repeat Pap test. High-grade cervical intraepithelial neoplasia is somewhat more likely to turn into cancer. The presence of these cells on a Pap smear result is called high-grade squamous intraepithelial lesion. Your doctor may recommend doing a more accurate examination of your cervix using colposcopy.
In a colposcopy, the cervix is examined with a special magnifying scope. If an abnormal-looking area is seen, the physician may biopsy the cervix. This involves removing a small piece of tissue to be examined under a microscope. That examination will determine the type and extent of abnormal cells.
Abnormal precancerous areas on the cervix are often treated with a procedure that uses an instrument to shave off tissue (called loop electrosurgical excision procedure). They can also be treated with a laser. These procedures can be done in a doctor's office with little or no anesthesia. Neither procedure should affect your fertility.
If a lot of the cervix is covered by cervical intraepithelial neoplasia, you may need to have a cone biopsy to remove more tissue. A cone biopsy makes carrying a pregnancy to term more difficult, but not impossible. After treatment, your doctor may recommend more frequent Pap smears to identify any new abnormal cells as early as possible.