Cervical cancer is one of the most preventable cancers in medicine — because it has a long, detectable precancerous phase, a well-characterized causative agent (human papillomavirus, or HPV), and an effective screening system that identifies abnormal cells before they become invasive cancer. When the screening system works — when a Pap test or HPV test identifies an abnormality — it is not a failure. It is the system doing exactly what it was designed to do: catch changes early enough to monitor them, treat them when needed, and prevent cancer from developing.
The challenge is that the language of cervical screening results — ASCUS, LSIL, HSIL, CIN 1, CIN 2, CIN 3, NILM, high-risk HPV positive — is opaque and frightening to most women who receive it without adequate explanation. The gap between what a result means clinically and what a woman fears it means when she reads it in a patient portal is significant, and it produces unnecessary anxiety for the majority of women whose results require surveillance or minor intervention rather than cancer treatment.
This cluster covers every major component of the cervical health pathway — from understanding what Pap and HPV test results mean, through the colposcopy evaluation that follows abnormal results, through the specific procedures used when treatment of cervical dysplasia is indicated. Each page is designed to replace anxiety with understanding.
Understanding how the cervical health pathway works helps contextualize every step within it. Each page in this cluster covers one stage of the pathway in depth.
Cervical Cancer Screening — Pap Test and HPV Test
Cervical cancer screening uses two complementary tests: the Pap test (cervical cytology), which looks for abnormal cervical cells, and the HPV test, which identifies high-risk HPV strains associated with cervical cancer development. Current guidelines recommend a combination of both tests (co-testing) every 5 years for most women aged 30 to 65, or Pap test alone every 3 years for women aged 21 to 29. The screening interval and co-testing versus Pap-alone recommendations are determined by age. Pap vs HPV test explained →
Abnormal Pap Results — What They Mean
Pap test results describe the appearance of cervical cells under a microscope. The most common abnormal results — ASCUS (atypical squamous cells of undetermined significance) and LSIL (low-grade squamous intraepithelial lesion) — reflect mild cellular changes that usually resolve without intervention. HSIL (high-grade squamous intraepithelial lesion) reflects more significant changes that warrant prompt evaluation. None of these results means cancer — they describe the degree of cellular change on the spectrum between normal and cancer. What abnormal Pap means →
HPV Positive — What Happens Next
A positive HPV test means a high-risk HPV strain is present on the cervix. Most HPV infections clear spontaneously within one to two years. Persistent high-risk HPV is what produces cervical dysplasia and, if untreated, can progress to cervical cancer over years to decades. The management pathway after a positive HPV result depends on which HPV strain is present, the Pap result in combination, and the patient’s history. HPV positive — what’s next →
Colposcopy — The Diagnostic Procedure After Abnormal Results
When a Pap or HPV result warrants further evaluation, colposcopy is the next step. A colposcope is a magnifying instrument used to examine the cervix in detail. Biopsies of any abnormal-appearing areas provide the histologic diagnosis — the definitive assessment of the degree of dysplasia present — that guides management. Colposcopy is a non-surgical office procedure that takes approximately 15 minutes. Colposcopy explained →
Cervical Dysplasia (CIN) — Grading and Management
Cervical intraepithelial neoplasia (CIN) is the histologic term for cervical dysplasia — precancerous changes in cervical cells identified on biopsy. CIN 1 is low-grade dysplasia that usually regresses spontaneously. CIN 2 and CIN 3 are higher-grade changes that have a meaningful probability of progression to cancer without treatment and are managed with cervical excisional procedures. Cervical dysplasia explained →
LEEP and Cold Knife Conization — Treatment Procedures
LEEP (loop electrosurgical excision procedure) and cold knife conization are the two primary cervical excisional procedures used to treat high-grade cervical dysplasia. Both remove the transformation zone — the region of the cervix where dysplasia arises — to provide both definitive treatment and a histologic specimen for pathologic evaluation. LEEP is performed in the office under local anesthesia. Cold knife conization is performed in the operating room under general or regional anesthesia. LEEP procedure → | Cold knife conization →
Most abnormal cervical screening results are managed through scheduled follow-up appointments. Contact our office promptly if:
- You received an HSIL or ASC-H result and have not yet scheduled your colposcopy — these results should be evaluated within 4 to 6 weeks
- You develop new or unexplained vaginal bleeding, particularly postcoital bleeding or postmenopausal bleeding, alongside an abnormal cervical result
- You have significant new pelvic or lower back pain alongside an abnormal cervical result
Cervical health evaluation, colposcopy, and cervical procedures are performed by Dr. Ramona D. Andrei, MD, PhD, FACOG — with a clinical approach that provides thorough explanation alongside thorough evaluation.
Screening and Result Interpretation
Cervical cancer screening is performed at well-woman visits at the intervals recommended by current guidelines. Abnormal results are communicated with a clear explanation of what the result means, what the next step is, and why. No abnormal result should be communicated without adequate explanation of its clinical significance — and that is the standard at Lapeer Women’s Health.
In-Office Colposcopy
Colposcopy is performed in-office at both our Lapeer and Rochester Hills locations. The procedure includes a detailed examination of the cervix with the colposcope, application of acetic acid to highlight abnormal areas, and targeted biopsy of any areas of concern. Results are reviewed with the patient and a clear management plan is established based on the biopsy findings.
LEEP and Cervical Procedures
LEEP is performed in-office under local anesthesia. Cold knife conization is performed at our affiliated Michigan hospitals when the clinical indication requires surgical conization. Post-procedural pathology results are reviewed and follow-up surveillance is established based on the final pathologic diagnosis and current guidelines.
Every year, thousands of women receive abnormal Pap or HPV results and spend weeks or months in unnecessary fear because the result was not explained clearly. An abnormal result means the cervical screening system detected a change that warrants follow-up. For the vast majority of women, that follow-up confirms a low-grade finding that resolves on its own or is easily treated with an in-office procedure. The outcome of detecting a change early — with clear information, appropriate follow-up, and targeted treatment when needed — is the prevention of cervical cancer. That is exactly what this system is for.
Dr. Ramona D. Andrei and the team at Lapeer Women’s Health are here to provide that follow-up — and the clear explanation that should accompany every step of it — at both our Lapeer and Rochester Hills offices, without a referral required.
Cervical Health and Screening
Our team at Lapeer Women’s Health provides cervical health evaluation, colposcopy, and cervical procedures at both our Lapeer and Rochester Hills offices. No referral required.
Schedule a Gynecologic VisitThe information on this page is intended for educational purposes only and does not constitute medical advice. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.