HPV and Abnormal Pap Smears (CIN 1, 2, 3): What Your Results Really Mean

What Is HPV and Why Does It Matter?

Human Papillomavirus (HPV) is a group of over 200 related viruses and the most common sexually transmitted infection worldwide. Most people will encounter some strain of HPV during their lifetime. HPV is broadly divided into two clinically relevant categories:

• Low-risk strains: These "harmless" viruses can cause genital warts (condylomas). While physically and psychologically unpleasant, they do not cause cancer.
• High-risk (oncogenic) strains: About a dozen high-risk types exist, with HPV 16 and HPV 18 being the most dangerous. A persistent, untreated, silent chronic infection with these strains can cause deep cellular mutations in the cervix, leading to cervical cancer — as well as cancers of the rectum and throat.

The good news: your immune system clears up to 90% of HPV infections naturally within 18–24 months. The alarm sounds when the virus persists for years, evading the immune system and quietly driving cellular changes. Without regular preventive screening, you would have no way of knowing.

How to Read Your Pap Smear Results

The Pap test (Papanicolaou smear) directly identifies pathological cellular changes on the cervix. Here are the key abnormal findings you may see on your lab report:

1. ASCUS (Atypical Squamous Cells of Undetermined Significance)

The first level that triggers medical attention. This indicates "slightly unusual" cells on the cervical surface. Common causes include benign vaginal yeast infections or hormonal changes (e.g., atrophic tissue during menopause) — they are not an automatic sign of cancer. A follow-up HPV test or repeat screening quickly resolves any concern.

2. LSIL — Low-Grade Dysplasia (CIN 1)

Indicates mild cellular changes, most commonly caused by an initial-phase high-risk HPV infection. In 70–80% of immunologically healthy women, CIN 1 resolves completely on its own within about one year — without any medical intervention.

3. HSIL — High-Grade Dysplasia (CIN 2 and CIN 3)

This is a serious finding requiring immediate action. In CIN 2, abnormal cells extend deeper into the cervical tissue. CIN 3 (also called carcinoma in situ) involves the full thickness of the cervical lining and represents the final stage before potential invasion into deeper tissue (true cervical cancer). At this point, we schedule a treatment procedure to remove the affected tissue (conisation / LETZ).

What Happens Next? Your Diagnostic and Treatment Pathway

When your gynaecologist identifies significant abnormalities on a routine Pap smear (especially combined with a positive high-risk HPV result), the clinical protocol requires a colposcopy.

Colposcopy gives your gynaecologist a magnified, illuminated view of the cervical surface after application of a diagnostic solution. The doctor precisely identifies any potentially precancerous areas and, depending on severity, performs a targeted biopsy — a small tissue sample that gives the pathologist a definitive diagnosis of your condition.

Can the Gynaecologist Treat HPV — or Prevent Cancer by Removing Bad Cells Early?

• There is no pill that eliminates HPV in a few days. However, we can surgically remove the damaged areas caused by the virus — effectively preventing cervical cancer with a 100% success rate when caught in time.
• The procedure is performed routinely using LETZ (Loop Excision of the Transformation Zone), where a small surgical loop removes the affected tissue layer. Recovery is straightforward, with no deep shortening of the cervix, allowing the remaining healthy tissue to regenerate naturally.

Book a colposcopy and stop cancer before it starts at our online booking page.