Epithelial Cell Abnormality

When I tell a patient she has an abnormal Pap test, I know how scary that moment can feel. Many women immediately worry it means cancer. In most cases, it does not.

Epithelial cells cover the surface of your cervix. These cells are often replaced. Sometimes, when doctors look under a microscope, the cells look a little different. That difference is called an epithelial cell abnormality.

Changes like these are actually quite common. They may be caused by infection, irritation, or HPV. What matters most is how we follow up. Detecting changes early is how we prevent cervical cancer.

I have done thousands of Pap tests over my career. With more than 20 years in women’s health, I’ve seen just how powerful early action can be. That’s why I always remind my patients: an abnormal result is not the end. It’s the start of taking care of yourself.

Quick Answer: Epithelial Cell Abnormality

An epithelial cell abnormality means some cells on the cervix look different than expected. These changes happen often.

Most of the time, they are not cancer. However, some changes, if ignored, could develop into precancer. That’s why I recommend follow-up testing, such as an HPV test or a colposcopy.

Understanding Epithelial Cell Abnormalities (Bethesda System)

I use the Bethesda System to explain Pap results. It breaks cervical cell changes into clear categories so both my patients and I know exactly what to do next.

Dr Diane Solomon, who helped design this system, once said, “The point is clarity. Clear results lead to the right care.” I couldn’t agree more.

I understand how alarming it feels to read words like “high-grade” or “precancer” on a test result. But these terms do not mean cancer. They mean we need to take a closer look. And most of the time, we have time.

Research backs this up. One large study in Obstetrics and Gynecology found that about 60% of LSIL cases returned to normal within two years. Only a small number progressed.

I often pair Pap results with an HPV test. If high-risk HPV, like types 16 or 18, is present, that tells me we need closer monitoring or earlier action.

Cervical Cancer 101: How Abnormal Cells Progress (and How Screening Stops It)

Cervical cancer grows slowly. Almost every case starts with HPV.

According to the CDC, most HPV infections clear on their own in two years. But if the virus sticks around, it can start to change the cervical cells. At first, the change is mild, what we call dysplasia. Many mild changes clear naturally.

If HPV doesn’t clear and the cell changes continue, they can become more serious. This process can take a decade or longer. That slow timeline is why regular Pap and HPV testing is so effective, it gives us a wide window to act before cancer ever develops.

The National Cancer Institute reports that cervical cancer deaths in the U.S. have dropped by more than half since we made screening routine. 

So I always tell patients: an abnormal Pap is not a diagnosis. It’s a signal. It’s the body’s way of saying, “Let’s take a closer look.”

The Screening Pathway (Pap + HPV → Colposcopy → Biopsy)

A Pap test is the first step. It checks the surface cells of your cervix for changes. Often, I add an HPV test to see if any high-risk HPV types are present.

If both tests are normal, you return to routine screening.

If I see mild changes, I might recommend repeating the Pap or HPV test in 6 to 12 months.

If results suggest high-grade changes, I’ll schedule a colposcopy. During that exam, I look at the cervix through a microscope called a colposcope. If I see anything that looks concerning, I take a biopsy, a tiny sample of tissue. That biopsy gives us the clearest answer.

This step-by-step process is why regular screening works so well. It gives us multiple chances to catch and treat problems early.

As for timing, I follow the USPSTF guidelines:

• Ages 21-29: a Pap every three years

• Ages 30-65: a Pap every three years, an HPV test every five years, or both every five years

Risk Factors for Cervical Abnormalities and Cancer

HPV is the main cause of cervical cell changes. But it’s not the only factor I consider.

• HPV types 16 and 18: These two cause about 70% of all cervical cancers.

• Smoking: This doubles your risk. The chemicals weaken both cervical cells and the immune system.

• Weak immune system: Conditions like HIV or immunosuppressant drugs make it harder to clear HPV.

• Sexual history: Having sex at a young age or having many partners increases HPV exposure.

On the flip side, protection works. Vaccines like Gardasil 9 prevent the most dangerous HPV types. In fact, a 2020 Lancet study showed the vaccine cut cervical cancer cases by nearly 90% in young women.

And never underestimate the role of a strong immune system. Good sleep, balanced nutrition, and managing stress all help your body fight infections naturally.

Management: From Watchful Waiting to Treatment

Not every abnormal result needs treatment. Many mild changes go away as your immune system clears the virus. I often recommend monitoring first.

When we do need to treat, the options are safe and effective:

• LEEP: Uses a thin wire with electric current to remove abnormal cells.

• Cone biopsy: Removes a small, cone-shaped piece of tissue from the cervix.

• Cryotherapy: Freezes off the abnormal cells.

• Laser therapy: Burns away the cells using light.

Most women recover quickly, usually within a few days. Some spotting or cramping is common, but serious side effects are rare.

What matters most is follow-up. I always stress this. Missing appointments is the biggest risk I see. When we stay on top of care, we stay ahead of the problem.

Cervical Cancer: Early Signs, Staging, and When to Seek Care

Cervical cancer can develop without any early warning signs. That is one reason I stress routine Pap and HPV testing so strongly. When we catch changes early, we have more treatment options and better outcomes.

If symptoms do show up, they may include:

• Bleeding after sex

• Bleeding between periods

• Pain during sex or pelvic pain

• Unusual discharge, sometimes with blood or a strong odour

If you ever notice these signs, please do not wait. Call your doctor right away.

When I diagnose cervical cancer, I refer patients to a gynecologic oncologist and they will stage  the patient and how far the disease has progressed. 

• Stage 0: Very early, only abnormal surface cells, often referred to as CIN

• Stage I: Cancer is only in the cervix

• Stage II: It has spread just outside the cervix

• Stage III: It has reached the lower vagina or pelvic walls

• Stage IV: It has spread to distant organs

Outcomes depend on the stage at diagnosis. According to the American Cancer Society, the five-year survival rate for Stage I cervical cancer is over 90%. That rate drops significantly in later stages.

Patients often ask me about the difference between precancer and cancer. I explain it this way:

The key takeaway is simple: catch it early. That is the goal of everything we do in cervical cancer screening.

Lifestyle, Prevention, and Immune Health

When a woman hears that her Pap result is abnormal, one of the first things she asks me is, “What can I do to protect myself?”

I usually walk her through two important steps.

First, the HPV vaccine. This vaccine targets the HPV strains most likely to cause cancer, especially types 16 and 18. I recommend it to girls and boys before they become sexually active. But even if you are older, it is worth asking whether vaccination could still benefit you.

Second, I stress the importance of routine screening. Pap smears and HPV tests do not stop infection, but they catch problems early. That’s when treatment is simplest and most effective. Missing your screening means missing that opportunity.

I also talk to patients about everyday choices. Smoking, for example, makes it harder for your body to fight HPV. Quitting helps immediately. Getting enough rest, eating nutrient-rich foods, and keeping stress in check all support your immune system. A strong immune response improves your chances of clearing HPV naturally.

That is part of why I created HPD Rx. I wanted to give women more ways to support their health, especially between appointments. Our physician-formulated supplements, such as AHCC, PAPCLEAR, and HPD Rx ONE, are designed to nourish immune function and fit into a wellness-focused lifestyle. They are not a treatment for abnormal cells, but they can help you feel proactive in supporting your body’s defences alongside your doctor’s care.

Conclusion

Getting a Pap result that shows abnormal cells can feel scary, but I want you to know this: most of the time, it does not mean cancer. These changes are common, and with proper care, they are manageable.

At HPD Rx, we believe in giving women tools to stay informed and supported. Our physician-formulated products, like AHCC, PAPCLEAR, and HPD Rx ONE, are designed to complement your wellness routine and support a strong immune system. They are not treatments, but they can be part of a proactive approach to your health.

You can explore more resources or take our wellness quiz here. And for any next steps, your doctor is your best guide.

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