What Pap Smears Don’t Diagnose

What does a pap smear test for, and what happens after an abnormal pap smear? In this episode of SHE MD, Mary Alice Haney interviews Dr. Thaïs Aliabadi to break down exactly what a pap smear is, how HPV affects cervical cancer risk, and what women need to know about abnormal results.  A pap smear is a cervical cancer screening test that checks for precancerous and cancerous cells on the cervix. A pap smear does not test for ovarian cancer, uterine conditions, or all sexually transmitted infections. HPV testing is often performed at the same time because high risk HPV is the leading cause of cervical cancer.

Can you have HPV with a normal Pap smear? What actually happens after an abnormal result? Dr. A answers these questions and more, explaining that while most HPV infections clear on their own within one to two years, monitoring and follow-up are key. The bottom line: cervical cancer is highly preventable with routine Pap and HPV screening—but annual well-woman visits are still essential for protecting your long-term health.

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What You’ll Learn:

What a pap smear actually tests for and what it does not screen

How HPV and pap smear testing work together to prevent cervical cancer

What abnormal pap smear results like ASCUS, CIN1, CIN2, and CIN3 mean

When a normal pap smear still requires follow up or colposcopy

Why regular pap smear screening makes cervical cancer almost entirely preventable

Key Timestamps:

00:00 Introduction

02:00 What a pap smear tests for and what it does not check

03:40 HPV explained: low risk vs high risk and why it’s common

05:15 Screening guidelines and why pap smear alone is not enough

07:15 What types of results you can get back from a pap smear

17:20 When you need a colposcopy and what happens during the procedure

22:15 Biopsy results and CIN staging explained

34:00 Treatment options: cryotherapy, LEEP procedure, and cold knife cone

35:40 Risks of aggressive LEEP and pregnancy considerations

38:00 HPV dormancy and common misconceptions

41:45 HPV vaccine recommendations and prevention

43:00 Final takeaway: pap smear schedule vs well woman exam

Key Takeaways:

A pap smear screens for cervical cancer and HPV, not STDs, ovarian cancer, or uterine conditions

High risk HPV, especially types 16 and 18, may require colposcopy even with a normal pap smear

Colposcopy and cervical biopsy confirm whether precancer cells are present and guide treatment

Most HPV infections clear naturally within one to two years

Cervical cancer is preventable with routine pap smear and HPV screening, but annual well woman exams remain essential

Resources Mentioned in This Episode:

🌐HPV Vaccine Information (CDC): https://www.cdc.gov/vaccines/vpd/hpv/index.html

🌐Cervical Cancer Screening Guidelines (ACOG): https://www.acog.org/womens-health/infographics/cervical-cancer-screening

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