What does my Pap smear result mean?
A Pap smear result shows whether there is any change in the cells of the cervix. NILM means normal. Terms such as ASC-US, LSIL, HSIL, ASC-H and AGC describe different degrees of change, and each calls for a different follow-up path. The key point: most of these results are not cancer, and they are not read on their own. They are assessed together with your HPV type, your age and your previous tests. Your doctor decides the next step.
When you get your Pap smear result, the abbreviations on it can look unfamiliar and worrying: NILM, ASC-US, LSIL, HSIL… Below you will find what each one means and what usually happens next. Let us start with the most important message: most of these results are not cancer, and they are assessed as part of the whole picture, not on their own.
What does a Pap smear result show?
A Pap smear assesses how cells taken from the cervix look. The result describes whether there is any change in the cells and, if so, its grade. It is not a "do I have cancer?" test. It is a tool for catching possible precancerous changes early. The result is always interpreted together with your HPV result, your age and your previous tests.
NILM: a normal result
NILM ("negative for intraepithelial lesion or malignancy") means your Pap smear is normal. No precancerous cell change was found. The only thing you need to do is continue with the recommended screening schedule.
ASC-US: a borderline result
ASC-US ("atypical squamous cells of undetermined significance") is one of the most common abnormal results and describes a borderline change. Most of the time it is not cancer.
With ASC-US, the approach is usually decided together with an HPV test: if HPV is negative, follow-up is used; if it is positive (especially 16/18), a closer assessment may be considered.
LSIL: low grade
LSIL ("low-grade squamous intraepithelial lesion") describes a mild cell change and is often linked to a temporary HPV infection. Many cases of LSIL go away on their own, especially in young women. The approach depends on your age, your HPV result and your previous tests (monitoring or colposcopy).
HSIL / ASC-H: high grade
HSIL ("high-grade squamous intraepithelial lesion") and ASC-H ("atypical squamous cells, cannot exclude HSIL") describe more advanced changes and call for a closer assessment, usually a colposcopy. Even these results do not mean cancer. Treating precancerous changes in time is the step that actually protects you.
AGC: glandular cell changes
AGC ("atypical glandular cells") describes a change in the glandular cells of the cervix or uterus. It is less common and calls for a detailed assessment. Your doctor decides the approach.
What happens after the result?
Depending on the assessment, the general paths are:
- Follow-up / a repeat test after a set time (especially with borderline or low-grade results),
- Colposcopy (especially with high-grade results or HPV 16/18),
- A biopsy for a definitive assessment, when needed.
All the abbreviations explained in one place: HPV results glossary. About the test itself: the Pap smear and HPV-DNA test.
When should you see a doctor?
- If your Pap smear result contains an abnormal finding and you are not sure what it means,
- If it is time for your recommended repeat screening or colposcopy appointment,
- If you have symptoms such as bleeding after sex or bleeding between periods.
A Pap smear result is not a diagnosis; it is a signpost. The doctor who assesses you makes the correct interpretation, and most results are managed calmly.
Frequently asked questions
My Pap smear says ASC-US. Is it cancer?
No. ASC-US (atypical squamous cells of undetermined significance) describes a borderline change and is one of the most common abnormal results; it is usually not cancer. The next step is most often decided together with an HPV test.
What does NILM mean?
NILM means 'no precancerous cells (lesion) were seen', so your Pap smear is normal. You still continue with the recommended screening schedule.
What is the difference between LSIL and HSIL?
LSIL describes a low-grade cell change, and HSIL a high-grade cell change. HSIL calls for a closer assessment (usually colposcopy); with LSIL, the approach depends on your age and HPV result.
Can my Pap smear be abnormal while my HPV test is negative?
Yes, this can happen, and it usually points to a lower-risk situation. The results are interpreted together; your doctor decides the approach for this combination.
Does an abnormal Pap smear result require a colposcopy?
Not always. Whether a colposcopy is needed is assessed based on the grade of the Pap result, your HPV type (especially 16/18), your age and your previous results.
Sources
- National Cancer Institute (NCI) — Cervical Cancer Screening
- ACOG — Abnormal cervical screening results
- Republic of Türkiye Ministry of Health / General Directorate of Public Health
Note: This content was written independently, based on current scientific information published by the institutions above; it is not a direct copy of any text.
This article is for general information only; it is not a diagnosis or treatment recommendation and does not replace a medical examination. Please consult your doctor about your own situation. The content reflects scientific knowledge as of the update date above.