What happens if my Pap test result shows a high-grade change?

If your Pap test showed indications of a high-grade abnormality, you’ll be referred for a colposcopy and possibly a biopsy.

These steps are also sometimes recommended if you have more than one low-grade abnormal result within two or three years.

It’s safe to have a colposcopy or biopsy when you’re pregnant, but it’s suggested that you discuss it with your doctor and then make sure the specialist is aware of your pregnancy.

If you think you may have your period on the day of your appointment, call the practice or clinic and they’ll let you know if you have to change your appointment.


For a colposcopy, you’ll be referred to a specialist at a colposcopy clinic or to a gynaecologist with experience in performing colposcopies.

The specialist will use a colposcope to examine your cervix. The colposcope is like a large microscope, and provides a magnified view of your cervix and the extent of any abnormality.

You’ll be asked to remove your underpants and to lie on an examination couch that has special support rests for your legs. The doctor will usually provide you with a sheet to cover yourself during the examination. The specialist will insert a speculum (the same instrument used in your Pap test) and paint a special solution on your cervix to highlight any abnormal areas.

The specialist will then use the colposcope to closely examine those abnormal cells. The colposcope doesn’t actually touch or enter your body.


During the colposcopy examination, a small sample may be taken from any areas of the cervix that look abnormal. The collection of this small sample of tissue is called a biopsy.

The sample will be sent to a laboratory for testing. About two weeks later, your specialist will have the results.

You should discuss with the specialist how you will obtain the results when they are ready.

When you are told the results, your specialist will also explain if any treatment is necessary.

Discomfort and ‘spotting’

The colposcopy or biopsy takes about 15 minutes. There may be some discomfort while the speculum is inserted. You may also have some cramps, similar to those experienced during your period, after the colposcopy or biopsy.

If there is some spotting:

  • use sanitary pads, not tampons
  • have showers instead of baths
  • avoid sexual activity
  • avoid spas and swimming pools.

If you bleed more than you do during your period, or if the bleeding continues for more than a week, call the clinic where you had the colposcopy for advice.

Pathway for management of high and low-grade changes

(Click image to enlarge in new window)

NCSP low and high grade pathway


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