Getting a call or message that says your cancer screening came back abnormal can make your heart stop for a moment. Your mind might race straight to the worst-case scenario.
But here’s the most important thing to know: Abnormal results do not always mean you have cancer. Many people who get an abnormal screening result end up being just fine. What those results mean is that your care team needs a closer look. Think of it as the start of a process and not the end of the road.
If you get abnormal results, here’s what you can expect to happen next so you feel a little more prepared and less overwhelmed.
What does “abnormal” really mean?
Screening tests look for early signs of disease before you have symptoms. They are designed to catch even small or unclear changes. As a result, screening tests are highly sensitive. That sensitivity is helpful but it also means the test may pick up things that are not cancer.
“Most abnormal screening results are found to be benign with additional testing,” said Arseña Smith, FNP, a family nurse practitioner with Banner MD Anderson Cancer Center at Banner Gateway Medical Center. “If an abnormality is noted, it just means that more focused testing is needed to determine what it is.”
An abnormal finding could be:
- A cyst or benign growth
- Scar tissue
- Inflammation or infection
- A shadow or unclear image
- A change that simply needs a closer look
What happens after an abnormal test result
If you receive an abnormal or inconclusive scan or test result, your health care provider will recommend follow-up steps. The specific steps depend on the type of screening you had and what the result showed.
Here’s a general look at how the process usually unfolds:
Step 1: Your provider reviews the results
After your screening, a radiologist or specialist reviews the images or lab results. If something looks unclear or different from expected, they will recommend follow-up testing.
Your primary care provider or specialist will then:
- Explain what was found
- Tell you how urgent it is (many are not urgent)
- Recommend next steps
At this stage, your provider may not have all the answers yet and that is normal. The goal is to gather more detailed information.
Step 2: You may need more imaging or testing
The most common next step is diagnostic imaging. These tests provide a closer, more detailed view of the area in question. The type of imaging depends on the original screening. For example:
- Breast screening: A follow-up may include a diagnostic mammogram, ultrasound or MRI
- Colon screening (like Cologuard): A colonoscopy may be recommended
- Prostate screening (PSA testing): You may need a prostate exam or prostate MRI
- Lung cancer screening: A CT scan may be repeated or reviewed more closely
These tests help providers look at:
- Size
- Shape
- Edges (smooth or irregular)
- Density
- Changes over time
In many cases, this extra imaging is enough to show that the finding is harmless.
Step 3: You may be referred to a specialist
If the finding needs more evaluation, your provider may refer you to a specialist. This might include:
- A breast specialist
- A gastroenterologist
- A urologist
- An oncologist or surgeon
The specialist will review your results, ask questions and guide you through the next steps. This doesn’t mean something serious is confirmed. It simply means you're receiving expert care for a closer look.
Step 4: A biopsy might be recommended
If your imaging isn’t clear, your provider may recommend a biopsy. A biopsy is a procedure where a small piece of tissue is taken and tested.
“A biopsy is the gold standard for diagnosis,” Smith said. “A tissue sample evaluated by a pathologist under a microscope with special stains can give a clear diagnosis.”
There are different types of biopsies, including:
- Needle biopsy
- Endoscopic biopsy (done during procedures like a colonoscopy)
- Surgical biopsy (less common)
A biopsy might sound scary but it’s usually not. Most biopsies are simple, minimally invasive procedures done in an outpatient setting.
Step 5: Waiting for results
This is often the hardest part. After more tests or a biopsy, it may take days to weeks to get the results. During this time, it’s common to feel anxious and unsure. Waiting for answers can be difficult.
Smith understands this challenge and gives some helpful advice. “Focusing on what you can control during this time is important,” she said.
Here are some things you can do to help:
- Keep your normal routine
- Get enough sleep
- Eat well
- Stay active
- Spend time with people you trust
- Try journaling or meditation
Smith also recommends staying off the internet about your results until you know more. Without proper context, online information can make you feel more stressed.
If you’re unsure about anything, ask your care team:
- When your results will be ready
- How you will get your results
- Who to contact if you have questions
Step 6: Ongoing monitoring in some cases
Sometimes, advanced imaging gives a clear enough picture that a biopsy isn’t needed right away. In these cases, your care team might recommend monitoring the area over time with repeat imaging.
“Continued imaging surveillance may also be indicated to assess the stability or growth of a tumor over time,” Smith said.
What if it turns out to be cancer?
It's normal to think about this possibility. If your doctor finds cancer, they will guide you through the next steps. These might include:
- More tests to find out the stage
- A treatment plan made just for you
- A team of specialists to help support you
Remember, screening often finds cancer early when it is more treatable.
The bottom line
Abnormal cancer screening results can feel overwhelming but they are not the final answer. Most abnormal results are not cancer. Instead, they show that your care team needs to take a closer look.
Your team may suggest follow-up steps like more imaging or a biopsy. Each step helps your team understand what is going on. Take it one step at a time. Ask questions. Stay in contact with your care team. Remember, this process is about finding answers, not assuming the worst.
If you have questions or worries about a recent test, talk to your health care provider. You can also ask to meet with a Banner Health specialist.
Common questions after an abnormal screening
Does an abnormal cancer screening mean I have cancer?
No. Screening tests are designed to catch anything unusual, which can sometimes lead to a false positive.
Should I be worried about abnormal results?
It is normal to feel worried but an abnormal result is not a diagnosis. It is the first step in getting more information.
How long does it take to get answers?
It depends on the test needed. Some answers come quickly, while others may take a few weeks.
What happens after an abnormal screening test?
You may need additional imaging, a biopsy or monitoring to better understand the findings.
