Smear test results explained

Dr Davina Deniszczyc Dr Davina Deniszczyc Medical Executive Director, Nuffield Health
Smear tests are a key part of looking after your health, but women can be anxious about the results. Nuffield Health's Medical Executive Director, Dr Davina Deniszczyz, explains the different types of smear results and what they mean for you.

If you're having a smear test, there's probably many things you'd rather be doing but few that are as important to your health. The test can identify Human Papilloma Virus (HPV) and cervical cell changes (dyskaryosis) that can increase the risk of cervical cancer. Sometimes there's a need for further tests or a repeat smear but that doesn't mean you should start preparing for the worst.

About 1 in 20 smears note abnormal cell changes and most of these changes won't lead to cervical cancer. But in some cases the abnormal cells will need to be removed so they can't become cancerous. HPV and cell changes aren't tied together. One can be positive, the other negative, or both could be present at various levels. All these outcomes mean different things for you.

We recommend Dual Testing where we screen for high-risk HPV and abnormal cells using liquid based cytology. It is important to remember that having a positive HPV test does not mean you will get cancer, but it increases your risk of the disease so it is important you attend all your cervical screening invitations.

Normal smear

Normal smear / negative for high risk HPV

What it means: No abnormal cell changes are noted and there's no evidence of high risk HPV. You have a very low chance of developing cervical cancer, but it's not a guarantee that cervical cancer won't occur.
What you should do: Attend your routine smear in three to five years depending on your age.

High risk for HPV

Normal smear / positive for high risk HPV

What it means: No abnormal cell changes are noted but there is evidence of high risk HPV.
What you should do: Attend for a follow up smear in 12 months to see if there is change in the cervical cells and whether or not the HPV is gone.

Borderline or low grade dyskaryosis

Borderline or low grade dyskaryosis / negative for high risk HPV

What it means: Some abnormal cell changes are noted but there's no evidence of high risk HPV. You're at very low risk of developing cervical cancer before your next next smear.
What you should do: Attend your routine smear in three to five years depending on your age.

Moderate or high grade dyskaryosis

Moderate or high grade dyskaryosis / negative for high risk HPV

What it means: Abnormal cell changes are noted but there's no evidence of high risk HPV. Further testing is needed.
What you should do: You will be advised to have a colposcopy.

Dyskarosis / positive for high risk HPV

Borderline or low grade dyskaryosis / positive for high risk HPV

What it means: Some abnormal cell changes are noted and there is evidence of high risk HPV. Further testing is needed.
What you should do: You will be advised to have a colposcopy.

Moderate or high grade dyskarosis / positive for high risk HPV

What it means: Abnormal cell changes are noted and there is evidence of high risk HPV. Further testing is needed.
What you should do: You will be advised to have a colposcopy.

Remember, being asked to attend for a colposcopy doesn't mean you have or will get cervical cancer. The results will help to determine your next steps.

Inadequate results

What it means: There are not enough cervical cells present for examination under a microscope. There are many reasons why the sample is inadequate. It's not a reason to be concerned.
What you should do: Attend for a repeat smear after about three months.

HPV vaccination

If your test for high risk HPV was negative, you will be eligible for vaccination. We offer vaccination with Gardasil® which protects against the high risk types of HPV and some strains which are associated with genital warts. Gardasil is also available to males.

Vaccination is not a substitute for routine cervical screening.

Last updated Tuesday 15 June 2021