Cervical Screening Programme
Department of Health
The Government of the Hong Kong Special Administrative Region

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After the smear is taken, your doctor or nurse will tell you when the result will be available and how to inform you of the result. Ask them if you are unsure of it. The report is usually available within a few weeks and your doctor may explain the result to you. You may be contacted earlier if the smear could not be examined properly for some reasons or if abnormality is detected. If you have not heard of the result after the expected notification date, call your service provider. The result of a cervical smear is usually reported using a standard set of terms called the Bethesda System (i) Interpretation of Results (ii) What is a "false negative" result? (iii)What is a "false positive" result? (iv)Implication of Different Results (v)What happens if result is abnormal?   (i) Interpretation of Results It is important to remember that cervical smears look for changes before cancer develops. A "negative" result means that no abnormal cell was found in your cervical smear specimen. A "positive" or "abnormal" result usually means there are some early changes in the cells of your cervix. If you are told you have an abnormal or positive smear, it could be a reaction to a virus, or you may have pre-cancerous cells which need treatment to prevent cancer from developing. Talk to your doctor about the next steps. (ii) What is a "false negative" result? Although cervical smear is currently the most effective way to prevent cervical cancer, no test is perfect. About 5-20% of cervical smears will be false negative results. A false-negative result is a cervical smear wrongly gives a normal result for abnormal lesion in the cervix. A false negative result could be due to sampling, transfer or laboratory error. A 'negative' or 'normal' result would mean low risk of having cervical lesion, but not no risk at all. Because it takes a long time for cervical cancer to develop, having regular smears can compensate the adverse effect of a false negative result. Furthermore, you should consult a doctor immediately if any vaginal symptoms develop, even though your recent smear is reported as negative. (iii)What is a "false positive" result? If a cervical smear wrongly gives an abnormal result for a normal cervix, this is called a false positive result. It is usually due to normal cells being mistaken as abnormal cells or lesions may have regressed to nomal and are no longer detected by repeated smears. When a woman's cervical smear is reported as abnormal, cervical smear may be repeated or colposcopy with biopsy may be performed. Through these examinations, false positive results will be detected and results of these investigations will show that the cervix is normal. (iv) Implication of Different Results Inadequate Insufficient cells on the slide or suboptimal preparation of the slide Repeat smear Normal (negative) No abnormal cells identified Routine follow up Inflammatory Cells could not be seen clearly due to infection or inflammation of the cervix Treatment and repeat smear in some cases ASCUS (Atypical Squamous Cells of Undetermined Significance) Borderline cell changes. This means that slight cell changes were seen but they were so near normal that they are probably nothing to worry about. Majority of these changes will revert to normal on their own Repeat smear within 4-6 months. Remember to go for your repeat smear and don't assume that these changes will go back to normal. If changes persist or become worse, you may need treatment. LSIL (Low grade Squamous Intraepithelial Lesion) Mild cell changes in the cervix. 85% will regress spontaneously over 2 years; about 15% will worsen. 0.1% will become invasive if left ignored. Need colposcopy ± biopsy. Treatment may be necessary. HSIL (High grade Squamous Intraepithelial Lesion) Moderate or severe cell changes. There is 1-2% chance of becoming invasive cancer if untreated. Need colposcopy ±biopsy. Treatment is usually necessary after confirmation. After successful treatment, you are unlikely to have cervical cancer, if you continue to have regular cervical smears. Invasive carcinoma Found cells with features suggestive of invasive cervical cancer Urgent referral to gynecologist for investigation and treatment (v)What happens if result is abnormal? About 90% of smears are normal and 10% of smears are abnormal. An abnormal result does not necessarily mean cancer. If you have an infection, you will be given some treatment and have another smear later. For borderline cell changes, you may be asked to repeat the smear 4-6 months later as majority of these changes will revert back to normal by themselves without treatment. For mild to severe cell changes, you may require further investigation and treatment. Usually, colposcopy of the cervix will be performed.

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