The short answer: a positive HPV test or an abnormal smear (Pap test) is not a cancer diagnosis. Most HPV infections clear on their own within 1–2 years. What happens next depends on your result. Often it is simply a repeat test after an interval your doctor sets. Sometimes it is a colposcopy: a magnified look at the cervix in the clinic, with a tiny biopsy if an area looks abnormal. If the biopsy shows high-grade changes (CIN 2 or CIN 3), a short outpatient treatment called LLETZ (also called LEEP) usually removes them. A check-up test about 6 months later (the “test of cure”) shows whether the treatment has worked, and most women then return to routine screening.
Many women search for this as HPV positive kya hota hai (एचपीवी पॉजिटिव क्या होता है). This page follows the journey step by step, from the result to the all-clear. For what the HPV result itself means, see what a positive HPV test means; for more detail on each procedure, see colposcopy, LEEP and cone biopsy.
After an Abnormal Cervical Smear or Positive HPV Test: What Happens Next
Receiving an abnormal cervical smear result or a positive HPV test provokes understandable anxiety. It is important to put the result in context: an abnormal smear is not a cancer diagnosis, and in most cases, the cells are either mildly abnormal or the HPV will be cleared by the immune system within 12–24 months. The screening and colposcopy pathway exists to find and treat cell changes long before they could become cancer. To understand these cell changes, read understanding precancerous cervical changes.
Colposcopy: What to Expect
Colposcopy is an outpatient examination of the cervix using a magnifying instrument (colposcope) that stays outside the body. You lie in the same position as for a Pap smear. The doctor applies a mild vinegar-like liquid (acetic acid), and sometimes an iodine solution, to the cervix; abnormal areas show up white (acetowhite) or do not take up the iodine. The procedure takes 15–20 minutes, most women feel only mild discomfort, and it allows the doctor to find abnormal areas and take small targeted biopsies, which can feel like a brief pinch. You can usually go home straight afterwards; light spotting or a dark discharge for a few days is common.
A biopsy result takes 1–2 weeks and will confirm whether CIN 1, CIN 2, or CIN 3 is present, or whether the tissue is normal despite the abnormal smear. CIN (cervical intraepithelial neoplasia) means abnormal cells on the surface of the cervix; it is not cancer. Low-grade changes (CIN 1) often go away by themselves and are usually watched with repeat tests. High-grade changes (CIN 2 and CIN 3) are usually treated. Read more about what CIN 1, 2 or 3 means.
LEEP / LLETZ: Treating CIN
Large loop excision of the transformation zone (LLETZ or LEEP) is the most common treatment for high-grade CIN (CIN 2 and CIN 3). A thin wire loop powered by electrical current removes the transformation zone — where most CIN originates — with precise margins. The excised tissue is sent for histology to confirm complete excision. The procedure is performed under local anaesthetic in the outpatient clinic and takes about 10–20 minutes. Cure rates exceed 90% with a single treatment.
After LLETZ: most women go home the same day. Light bleeding or a watery or brownish discharge for a few weeks is common. Avoid sex and tampons until the team tells you it is fine. If you may want a pregnancy in future, ask about this before treatment: the amount of tissue removed is kept as small as safely possible. Contact the team on WhatsApp (+91 76988 00333), or go to the nearest emergency department, if you have heavy bleeding, a smelly discharge, a fever or pain that is getting worse.
Follow-Up and Test-of-Cure
After LLETZ, a test-of-cure smear with HPV co-testing is performed at 6 months. A negative HPV result at this point is highly reassuring and allows return to routine screening intervals. HPV persistence after treatment indicates higher risk and warrants continued surveillance with annual co-testing for 3–5 years.
HPV vaccination does not treat CIN or clear an existing infection, but it may protect against other HPV types; ask whether it is worth considering for you. See our HPV vaccination guide for India.
The important message: an abnormal smear with prompt follow-up is a success story. The system is working. Do not avoid colposcopy out of fear.
Dr. Nishtha Tripathi Patel performs colposcopy and LLETZ in Ahmedabad. Contact: +91 76988 00333.