Few sentences cause more alarm than an abnormal smear result, and most of that alarm is unnecessary. Cervical cancer is one of the few cancers screening can largely prevent rather than merely detect early, precisely because it is preceded by changes that remain treatable for years.
An abnormal result usually means cell changes, not cancer. The common categories run from borderline changes, through low-grade changes which frequently resolve on their own, to high-grade changes which are treated to stop them progressing. Only a small minority of abnormal results represent anything close to cancer.
What happens next depends on the grade and on the HPV result alongside it. Options include repeating the test after an interval, since many low-grade changes clear by themselves; HPV testing to clarify the risk; or colposcopy — a magnified look at the cervix, done in clinic, taking about fifteen minutes, with a small biopsy if something needs checking.
If treatment is needed it is usually a minor procedure to remove the affected area, done as an outpatient. It is highly effective and rarely affects future pregnancy, though that is worth discussing if you plan to conceive.
The single most important thing is not skipping the follow-up. Cervical changes are slow, which is what makes them so treatable — and also what makes it easy to postpone the appointment, and then postpone it again.
Bring the date and result of your previous screen if you have them, because they genuinely change the interpretation. See a doctor promptly if you have had an abnormal result and have not had the recommended follow-up, or if you have bleeding after sex, bleeding between periods, or unusual persistent discharge — those warrant assessment regardless of when you were last screened.