Precancerous Cervical Changes: They're Common and Treatable

• Updated 1/8/2021

  An abnormal Pap test result can be scary. If the term precancerous is mentioned, many women assume the worst. But precancerous changes that show up during a Pap test can mean many things.

  “There are different reasons why a Pap test can come back completely normal or suspicious for cancer, and there’s a whole myriad of things in between,” said Stephanie Angela King, MD, a gynecologic oncologist at Fox Chase Cancer Center.

  What are pre-cancerous changes?

  “Precancer means there isn’t cancer there yet, but if you don’t monitor or do something about it, it may develop into cancer,” King said.        

  These changes do not mean you’re on the brink of a serious illness. In fact, many women are told that they have precancerous cervical cells.

  “There are a million abnormal Pap smears each year,” King said. “Of those, 100,000 have serious precancer changes. And there are only 10,000 new cases of cervical cancer a year. That’s a lot of abnormal Pap smears for an actual small number of cancers.”

  Risk factors for cervical changes

  Some women are at a higher risk for precancerous cervical changes. American Cancer Society (ACS) pinpoints these risk factors:

  • Being infected with the human papillomavirus (HPV), a common sexually-transmitted infection
  • Smoking
  • Having a weakened immune system
  • Having a chlamydia infection
  • Being overweight
  • Having three or more full-term pregnancies
  • Having a family history of cervical cancer

  These factors can increase your risk but they don’t determine your future.

  “To decrease your risk, do whatever keeps your immune system working,” King said. “Eat a healthy diet, exercise, decrease your stress and get more sleep. These are things that will make your immune system more robust. Also, don’t smoke. Women who are smokers will have a higher rate of cervical cancer. Everybody focuses on how smoking is bad for your lungs or heart, but it can also decrease your body’s ability to mount an immune response.”

  Dr. King also recommends that preteens get the HPV vaccine, which helps protect against the infection. If they miss the recommended dosages beginning around age 11, they can still get the vaccine until their mid-20s.

  Treatment for cervical pre-cancer

  Treatment for precancerous cells identified during a Pap test can vary. In serious cases, it can mean surgery to remove abnormal cells, cryosurgery to freeze the cells, or laser therapy to burn away the cells. But more often the recommended treatment is monitoring the situation with more frequent Pap tests every six to 12 months.

  “Many times, what we will do is just follow these changes,” King said. “Many of these abnormalities are caused by the HPV virus. We can’t get rid of the virus for you—your immune system has to mount a response to it. Most of these cases can be followed up and monitored by your regular gynecologist.”

  Get screened for cervical cancer

  Take charge of your cervical health and get screened routinely. ACS recommends women begin this screening at age 21. From there:

  • Women 21 to 65 should have a primary HPV test every 5 years or if a primary test is not available, they should receive an HPV/Pap co-test every 5 years or a Pap test alone every three years.
  • Women older than 65 who’ve had regular screenings and no serious pre-cancers in the previous 20 years can stop screening.

  It is important to have a conversation with your physician about what cervical cancer screening schedule you should follow.

  There are a number of organizations that provide screening recommendations for cervical cancer. While the ACS has recently updated their recommendations to the above, other organizations may recommend a different timeline which includes screening women age 21-29 with a Pap test alone every 3 years and women aged 30-65 with a Pap test and HPV test (co-test) every 5 years or a Pap test alone every 3 years. Learn more about cervical cancer screenings.