Negative for intraepithelial lesion or malignancy (NILM)

by Omar Al-Nourhji MD FRCPC
March 22, 2022

What does the term negative for intraepithelial lesion or malignancy (NILM) mean?

Negative for intraepithelial lesion or malignancy (NILM) means that no pre-cancerous or cancerous cells were seen in your Pap smear. It is a normal result.

How do pathologists make this diagnosis?

The diagnosis of NILM is made after a Pap smear of the cervix is examined under the microscope by a laboratory technologist (cytotechnologist) or a pathologist. The smear will often show a variety of normal cells, such as squamous cells, endocervical cells, and metaplastic cells. In order to make this diagnosis, the Pap smear must include a sufficient number of squamous cells. The presence of cells from the transformation zone (endocervical or metaplastic cells) is used as a quality indicator but is not required to be present in every sample. Occasionally infectious elements (yeast, bacteria, and viruses) or normal cells shedding from the lining of the uterus (endometrium) may be present on the Pap smear.


What happens after this diagnosis?

NILM is a normal result and most women can continue to be screened at regular intervals. The interval may vary based on your age and the result of an additional test for human papillomavirus (HPV), the virus responsible for increasing your risk for cervical cancer. Talk to your doctor about the screening interval that is right for you.

Other helpful resources:

Choosing Wisely Canada

Cancer Care Ontario

Canadian Cancer Society

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