Called Back for Abnormal Cervical Cells but Not Told the Result by Phone: Does It Mean Cancer? What Pap/HPV Results Mean, Colposcopy and LEEP Steps, and How to Prepare for the Appointment

A single mother asks: after my annual check-up, the nurse called me in because abnormal cells were found. She would not say whether it is cancer. My face and hands went numb and I am terrified

Direct answer: being called back does not tell you how serious the result is. Abnormal results at every level that need colposcopy are scheduled the same way,
and the most common results are low-grade changes. Numb face and hands and a racing heart during the call are the body’s reaction to shock, and they are very common.

A member of a women’s health group focused on HPV and cervical cancer shared that she had an annual check-up under her social security coverage, including blood tests, a pelvic exam, and cervical screening.
A nurse then called to book a doctor’s appointment because abnormal cells were found. She is a single mother of children aged six and a half and nine, with the appointment only days away.
This article summarizes research and international guidance to help with preparation and questions for the doctor; it does not guess anyone’s result.

1. What “abnormal cells” means, and why it is usually not cancer

Direct answer: cervical screening is designed to catch changes before cancer develops. Most abnormal cells are low grade and can clear on their own, but a screening result is not a diagnosis; colposcopy and a biopsy are needed.

A follow-up study of 4,504 women (2007)
with ASC-US or LSIL found that 91% of HPV infections cleared within 24 months,
and a review of the natural history of CIN estimated that about 60% of CIN 1 regresses and about 1% progresses to cancer.

How long it takes to go from HPV to cancer

A Lancet review (2007)
concluded that persistent infection and precancer typically develop within 5–10 years, from fewer than 10% of new infections,
and that invasive cancer arises over many years, even decades, in a minority of women with precancer. This window is why screening works.

What cannot be known until you see the doctor

Some results, such as HSIL, ASC-H, or AGC, carry a higher risk of high-grade disease, and very rarely a screening result can point to cancer.
So nobody can promise over the phone that it is or is not cancer. But when it is precancer, which is most cases, treatment works very well.

What each screening result means and the next steps usually recommended under ASCCP 2019 (cards on mobile)

Based on the ASCCP 2019 guidelines,
which decide management from the combined risk of the current result and history; your doctor may choose differently based on your details. See also
NCI: Abnormal HPV and Pap test results.

2. Why the nurse would not give the result by phone

Direct answer: many hospitals require results that need explanation and a plan to be given in person by a doctor. Not being told by phone is routine, not a sign that the result is serious.

• The report must be interpreted as a whole: cell type, HPV result, and previous tests together. Deciding between colposcopy and repeat testing is the doctor’s job.
• Confidentiality: identity is hard to confirm by phone, so many hospitals do not share sensitive results that way.
• The nurse’s role is scheduling: saying “cancer” or “not cancer” before a doctor reviews the result could mislead either way.
• All abnormal results are scheduled the same way, from ASC-US to HSIL, so severity cannot be guessed from the callback.

What you can ask the nurse by phone

• How should I prepare, and will colposcopy or a biopsy be done at the appointment?
• How long should I avoid sex, douching, or vaginal medicines beforehand?
• What should I do if I have my period on the day?
• If I am very anxious, can the appointment be moved earlier?
• Can I get a copy of my result at the appointment?

This kind of worry is common

A systematic review (2016)
found that being called back and having colposcopy commonly causes anxiety. Knowing in advance what will happen at the appointment helps, which is the purpose of the next section.

3. At the appointment: colposcopy, biopsy, and LEEP

Direct answer: the visit usually starts with explaining the result and colposcopy. If a suspicious area is seen, a small biopsy is taken. LEEP is usually done after the biopsy result, except in some cases of HSIL on screening.

What colposcopy involves, and whether it hurts

Colposcopy
uses a magnifying instrument to look at the cervix from outside the body. A speculum is inserted as in a pelvic exam, and dilute acetic acid is applied so abnormal areas stand out; it takes about 10–20 minutes.
Looking itself is usually painless. A biopsy feels like a brief pinch or cramp, and light spotting or dark discharge for 2–3 days afterward is common.

The biopsy gives the CIN grade

The biopsy reports the grade of CIN (cervical intraepithelial neoplasia)
as CIN 1, CIN 2, or CIN 3, which determines whether to observe or treat. Details are in section 4.

What LEEP is and what to know

LEEP
uses a thin electrified wire loop to remove the abnormal area of the cervix, as an outpatient procedure under local anesthesia, in about 10–20 minutes.
A meta-analysis of 97 studies (2017)
found that about 6.6% still had residual or recurrent CIN 2 or worse after excision, and that post-treatment HPV testing predicted failure more accurately than margin status.
So excision is not the end of the story; follow-up visits matter.

If you may want children in future, tell your doctor beforehand, because a meta-analysis of 71 studies (2016)
found loop excision increased the risk of preterm birth about 1.56-fold, with risk rising with the depth of tissue removed, so doctors aim to remove only what is necessary.

4. How CIN 1, CIN 2, and CIN 3 differ, and how well treatment works

Direct answer: the higher the CIN grade, the lower the chance of clearing on its own. CIN 1 is usually observed and CIN 3 is usually excised, and adequate treatment lowers cancer risk dramatically.

A BMJ meta-analysis of 36 studies (2018)
found that over 24 months, 50% of untreated CIN 2 regressed, 32% persisted, and 18% progressed. A long-term CIN 3 study (2008)
found a 31.3% cancer risk over 30 years in untreated women, compared with 0.7% in those adequately treated. That is why keeping appointments matters most.

Lesion grade, standard approach, medicines or supplements, lifestyle, and follow-up (cards on mobile)

No medicine, herb, or supplement has been proven to clear HPV or make lesions regress. Standard care treats the lesion, not the virus.

5. Before the appointment: looking after your mind and preparing

Direct answer: what genuinely helps is preparing questions, arranging time and childcare, and limiting frightening searches. A few days of stress do not make lesions worse, and it is not your fault.

• Avoid sex, douching, and vaginal medicines for about 24–48 hours before the visit, or as the hospital advises
• Arrange childcare in case the visit runs long or colposcopy and biopsy are done the same day
• Bring someone you trust if possible, to help note what the doctor explains
• Bring sanitary pads and wear comfortable clothes
• When your face or hands go numb or your heart races, breathe out longer than you breathe in, for example in for 4 seconds and out for 6, for about 5 minutes
• Limit internet searching, read only reliable sources, and save questions for the doctor
• If you smoke, start quitting today; it is the modifiable factor with the strongest evidence for HPV persistence

Questions to ask the doctor at the appointment

1. What type of cell result do I have, and which HPV type?
2. Will colposcopy and a biopsy be done today, and when will results be ready?
3. If the biopsy shows CIN 1, 2, or 3, what is my plan?
4. If I need LEEP, how many days off work or self-care will I need?
5. If I may want children in future, what should I consider?
6. When is my next follow-up, and by which test?

Frequently asked questions (FAQ)

Common questions when called back after an abnormal cervical screening result

The hospital called to say abnormal cervical cells were found. Does that mean I already have cancer?

Usually not. Pap and HPV tests are designed to find changes at the precancer stage. The most common abnormal results are ASC-US and LSIL, which are low-grade changes, and many low-grade lesions clear on their own. A screening result is not a diagnosis, however. Some results such as HSIL, ASC-H, or AGC carry higher risk, so the doctor performs colposcopy and takes a biopsy if needed to confirm.

Why would the nurse not give the result by phone and ask me to see the doctor instead?

Many hospitals require results that need explanation and a follow-up plan to be given in person by a doctor, because the report combines the cell type and the HPV result, which must be interpreted with your history, and your identity must be confirmed to protect confidentiality. Being called in is the normal pathway for abnormal results at every level and does not mean the result is serious. You can ask the nurse how to prepare and whether colposcopy will be done at the appointment.

What happens at the appointment, and does colposcopy hurt?

The doctor explains the result and usually performs colposcopy. A speculum is inserted as in a pelvic exam, and dilute vinegar is applied so abnormal areas show up, which takes about 10 to 20 minutes. If a suspicious area is seen, a small biopsy is taken, which usually feels like a brief pinch or cramp. Light spotting or dark discharge for 2 to 3 days afterward is common, and biopsy results usually take about 1 to 2 weeks.

What are CIN 1, CIN 2, and CIN 3, and does everyone need LEEP?

CIN is the grade of abnormal cells on the biopsy. CIN 1 is low grade and about 60% clears on its own, so it is usually observed. About 50% of CIN 2 clears within 24 months, and the doctor may treat or observe depending on age and pregnancy plans. CIN 3 is usually treated by excision such as LEEP, because untreated CIN 3 carries a high risk of progressing to cancer.

Can precancerous lesions be cured?

Treatment works very well. A long-term study found that women with CIN 3 who received adequate treatment had only a 0.7% risk of cancer over 30 years, compared with 31.3% in those left untreated. After excision, about 6.6% still have residual or recurrent disease, so follow-up HPV testing as scheduled is essential and is the most accurate predictor of treatment success.

What is LEEP, how long is recovery, and does it affect pregnancy?

LEEP uses a thin electrified wire loop to remove the abnormal area of the cervix. It is done as an outpatient procedure under local anesthesia and takes about 10 to 20 minutes. Discharge or light bleeding can last several weeks, and sex, tampons, and baths are usually avoided for about 4 weeks or as your doctor advises. If you plan a future pregnancy, tell your doctor, because LEEP slightly increases the risk of preterm birth.

Does stress stop HPV from clearing, and how should I look after myself?

There is no clear evidence that a few days of stress before the appointment makes lesions worse. Worry at this stage is normal and is not your fault. The modifiable factor with the strongest evidence is stopping smoking and avoiding secondhand smoke. Good sleep, balanced meals, and exercise support overall health, but no medicine or supplement has been proven to clear HPV.

How should I prepare before the appointment?

Avoid sex, douching, and vaginal medicines for about 24 to 48 hours before the visit, or as the hospital advises. If you have a heavy period on the day, call to ask whether to reschedule. Write down your questions, ask for a copy of your result, bring someone you trust if possible, and arrange childcare in case colposcopy or biopsy is done the same day.

Scientific mechanism (brief)

Summary by Asst. Prof. Dr. Norawit Raatpiboon:
high-risk HPV infects the basal cells of the cervical lining at the transformation zone, where cells divide actively.
In most people the immune system clears the virus within 1–2 years, but when infection persists, the viral E6 and E7 proteins inhibit p53 and pRb, the proteins that control cell division.
Cells then divide abnormally, appearing as LSIL or HSIL on cytology and as CIN on biopsy, a process that usually takes years.
Dilute acetic acid makes cells with dense nuclei look white under magnification, allowing targeted biopsies.
LEEP removes the transformation zone containing abnormal cells, new tissue grows in its place, and repeat HPV testing shows whether the virus and lesion have been eliminated.

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