Abnormal Pap smear results are common to a gynecological practice. However, they create a lot of anxiety and stress for the patient who has an abnormal result. There are many different types of abnormal Pap smears including ones with atypical cells, low-grade dysplasia and high-grade dysplasia (pre-cancer), non-invasive cancer, and invasive cancer. The way an abnormal Pap test is managed depends on patient’s age and the specific result and ranges from observation or a follow-up Pap smear to performing a colposcopy or referral to a gynecologic oncologist. A colposcopy is a minor procedure performed in the office which looks more closely at the cervix with a microscope and sometimes includes a cervical biopsy and/or an endocervical curettage. Occasionally, high grade dysplasia (CIN2-3) is discovered and a patient needs a Loop Electrosurgical Excision Procedure (LEEP). A LEEP procedure removes a piece of the outer portion of the cervix to eradicate the disease. This procedure is usually done under local anesthesia (numbing of the cervix) in the office and is 90-95% curative.