The result of your smear will be reported to your smear taker by an NCSP approved laboratory.

Your result will also be reported to the NCSP and recorded on a computerised database called the NCSP Register.

When your first cervical smear test result is recorded on the NCSP Register, the Programme will send you a letter with that result.

For subsequent tests, including those for HPV, your smear taker will be advised of your result.  The Programme will contact you directly only if you have an abnormal result.  If your result is abnormal, you will be informed by mail and also advised of any follow-up needed.  This letter may take about two to four weeks to reach you.

If you would like to be sure that your result is normal, ask your smear taker to tell you.

What your cervical smear test shows

The result of your cervical smear test shows whether the cells taken from the surface of your cervix are normal or have changed in some way.  If some cells have changed, the test will indicate how they have changed.

Why you may need further tests

The cervical smear test is a screening test.  (See Glossary.)  If a screening test indicates abnormal changes, further diagnostic tests will be needed to identify the changes more exactly, for example, through colposcopy.

HPV is the main cause of abnormal cell changes that can lead to cervical cancer.  In some circumstances, HPV testing may be offered in conjunction with cervical smear tests.  Discuss this with your smear taker.

A cervical smear test uses very reliable techniques but may occasionally produce an unsatisfactory result.  Some women will be asked to come back for another smear test within three months if:

• there were not enough cells on the slide prepared by the smear taker or in the LBC sample
• blood or mucus was hiding most of the cells.

What the different results mean

Normal results

About nine out of ten cervical smears are normal.  If you have a normal result, you have a very low risk of developing cancer.

Inflammation or infection

Sometimes the laboratory will report that inflammation or an infection is present.  These changes are not linked to cancer.  You will need to discuss the result with your smear taker.  Often no treatment is needed.

Abnormal results

An abnormal cervical smear result means some of the cells on the cervix differ in some way from normal cervical cells.  An abnormal result hardly ever means cancer.  There are three main types of abnormal cervical smear test results, those that show:

• atypical cell changes
• mild (low-grade) changes
• moderate to severe (high-grade) changes.

Atypical cell changes

Atypical cell changes are associated with the squamous cells that line the vagina and outer layers of the cervix.  A result of atypical squamous cells of undetermined significance (ASC-US) indicates changes that are not clearly normal or abnormal.  Quite often, the next smear will be normal.  After a first atypical smear result, your smear taker may advise you to have another smear in 12 months or refer you for colposcopy, according to the Guidelines for Cervical Screening in New Zealand (2008).  An HPV test may be done after the atypical cells have been detected.  Depending on the result, you may be referred for colposcopy.

Mild (low-grade) changes

Mildly abnormal cells are called low-grade squamous intraepithelial lesions (LSIL).  This means there are mild changes in the surface cells of the cervix.  LSIL is the lowest grade of change.  Quite often, these cells will become normal again.  As for ASC-US (above), you will need to have your next smear in 12 months or have a colposcopy, according to the Cervical Screening Guidelines.  An HPV test may be done after the low-grade cells have been detected. 
If these changes persist or if you have a history of abnormal smear results, you will be referred for colposcopy.

Moderate to severe (high-grade) changes

Moderate to severe abnormal cell changes are called high-grade squamous intraepithelial lesions (HSIL).  In some women, these cell changes may develop into cancer if they are not treated.  You will be referred for colposcopy, and it is important for you to attend your colposcopy appointment.

Sometimes a result will show atypical squamous cells present and high-grade changes cannot be excluded (ASC-H).Women with this result are managed the same as those with an HSIL result.

Result	What this means	Recommended follow-up
Normal	Cells are normal	Next smear in 3 years
Unsatisfactory result	Not enough cells to give a result	Repeat smear within 3 months
Inflammation or infection	Inflammation or infection is present	Discuss possible treatment with your smear taker or doctor
Atypical cells (ASC-US)	Between normal and abnormal	Next smear in 12 months or referral for colposcopy*
Mild (low-grade) changes (LSIL)	Some cells are mildly abnormal	Next smear in 12 months or referral for colposcopy*
Moderate to severe (high-grade) changes (HSIL)	Some cells have more severe changes	Referral for colposcopy

* HPV testing may also be used to help determine management.

Glandular cell changes

Although the cervical smear test is not designed to detect glandular cell changes, such changes are sometimes found. You will be referred for colposcopy, and it is important for you to attend your colposcopy appointment.

Cancer

If your smear test shows any changes that might suggest cervical cancer, you will be referred immediately to a specialist (within one week).