If necessary, any abnormal cells can be removed to prevent cervical cancer developing. About 1 in 20 tests reveal mild cervical cell changes, most of which don't need treatment because they return to normal by themselves. Approximately 1 in cervical screening tests indicate moderate cell changes, and 1 in indicate severe cell changes. If you have moderate or severe cell changes, you'll be referred for a colposcopy and you may need treatment.
However, less than 1 in 1, women referred for a colposcopy are found to have invasive cervical cancer that requires immediate treatment. Read more about cervical screening tests. Although abnormal cervical screening results rarely indicate cancer, it's important to investigate all moderate and severe abnormal cell changes, so that any problems can be treated as soon as possible. You may also be referred for a colposcopy as a precaution if the laboratory was unable to get a result from your screening test sample.
A colposcopy allows the cervix and the tissue on its surface to be examined more closely. This gives a clearer idea of exactly where the abnormal cell changes are located and how advanced they are. A colposcopy isn't a treatment for abnormal cells, it's simply a way of examining cell changes in more detail.
However, treatment can be carried out during a colposcopy if abnormal cells are detected. A colposcopy is a safe and quick procedure.
However, some women find it uncomfortable and a few experience pain. Tell the doctor or nurse colposcopist if you find the procedure painful, as they will try to make you more comfortable. You'll be referred for a colposcopy if your cervical screening test reveals cervical cell changes, or symptoms such as unexplained pelvic pain or vaginal bleeding need to be investigated.
It will usually be carried out in the outpatients department of your local hospital. If you would prefer a female doctor or nurse to carry out your colposcopy, you can request this by phoning the clinic beforehand. You can also bring a friend, partner or family member to help you feel more at ease. Phone the clinic if your period is due on the day of your appointment.
In some cases, such as if it's your first colposcopy, you may still be able to attend your appointment. However, in other circumstances, such as if it's a follow-up appointment, you may need to reschedule the appointment.
You can have a colposcopy if you're pregnant. Don't have sex or use vaginal medications, lubricants, creams or tampons for at least 24 hours before your appointment. This will make examining your cervix easier. Take a panty liner to your appointment, as a small amount of discharge can come out of your vagina after the procedure. If a small cell sample a biopsy is taken, there may also be some bleeding. You'll be asked to undress from the waist down and lie on a special couch with your knees bent.
Your legs can rest on padded supports. If you prefer, you could wear a loose skirt that can be lifted up without having to take it off. A device called a speculum will be gently inserted into your vagina to hold it open and allow the colposcopist to take a closer look at your cervix — in the same way your cervical screening was done. A colposcope is used to examine the cells.
It looks similar to a pair of binoculars. The colposcope doesn't touch you — it stays about 30cm 12 inches outside your vagina and allows the colposcopist to see the cells on your cervix on a screen. In some cases, photos may be taken for your medical records. Your colposcopist may dab different liquids onto your cervix.
These stain abnormal cells a different colour, so they can be seen more clearly. You may feel a mild tingling or burning sensation when the liquid is applied to your cervix. If abnormal cells are found, a small sample of tissue a few millimetres across may be taken from your cervix a biopsy.
This shouldn't be painful, although you may feel a slight pinch or stinging sensation. If necessary, you may be given a local anaesthetic to numb the area. The tissue sample will then be sent to a laboratory for testing.
A colposcopy is a quick and safe procedure. It usually takes 5 to 10 minutes, but you should allow about an half an hour for the whole visit.
Most women find the procedure uncomfortable and some experience pain. Tell the colposcopist if you feel pain and they will try to make it more comfortable for you. You should be able to continue with your daily activities after your appointment, including driving.
For a few days after your colposcopy, you may have a brownish vaginal discharge, or light bleeding if you had a biopsy. This is normal and will usually stop after 3 to 5 days.
You should wait until any bleeding stops before having sex or using tampons, vaginal medications, lubricants or creams. Following a colposcopy, you should be invited to a follow-up appointment to check that the cells in your cervix have returned to normal. This will usually be 4 to 6 months after your colposcopy. After a colposcopy, your colposcopist will usually be able to tell you what they have found straight away.
If there is any uncertainty, a small sample of tissue from the cervix may need to be removed a biopsy for further examination. However, an abnormal result does not mean you have cancer. It simply means that there are changes to the cells which could potentially cause cancer in the future.
This is why cervical screenings help to save lives! This is otherwise known as the Wart Virus. Most women will fight the infection via their immune system, but for others, it can progress and result in dyskaryosis. There are more than different types of HPV and about 40 strains affect the genital areas and can be easily passed on through sexual contact.
Several of these are linked to cervical cancer, which is why they are medically referred to as high-risk HPV strains. Squamous cells are the cells which cover the surface of the cervix. The cervical canal, or endocervix, is lined with glandular or columnar cells and produces mucus. The area in which these types of cells meet is called the transformation zone and is where abnormal cells may form.
Your colposcopist will recognise the importance of the cervix to support future pregnancies and will tend to remove as little tissue as possible while making sure the treatment is successful. Women having had treatment for abnormal cells by loop excision may have a higher risk of preterm delivery in later pregnancies. Other treatments such as laser ablation or cold coagulation have not been associated with this adverse finding but these treatments may not be suitable for your problem.
A type of treatment called cone biopsy this usually requires admission to hospital and is performed whilst you are asleep with a general anaesthetic or repeated treatments may also result in early delivery. If you have had multiple treatments and are pregnant or considering a pregnancy then you should speak to your GP or obstetrician.
While there currently appears to be no ideal way to judge this risk, there are ways that it can be managed. You should discuss your previous treatment with your obstetrician who sometimes may advise a special scan early in pregnancy to measure the length of your cervix.
In most cases this is normal, but if not your doctor may recommend a cervical stitch or cerclage to provide additional support. This is generally inserted when you are pregnant with a short general anaesthetic and removed whilst you are awake shortly before your baby is due. If you have had treatment to the cervix after having had an abnormal smear, it is important to have a smear check about 6 months later. This is to see that the treatment has been effective.
This is usually at your Colposcopy clinic, but sometimes this can be back with your GP or practice nurse. A lot of clinics also invite you for a follow-up colposcopy examination at this stage and will take the smear as well. From you may in addition have a special test to check that any infection with the human papillomavirus HPV has resolved. If all is normal at this stage you will simply have annual smears for a number of years depending on your specific circumstances before going back on the normal 3 or 5 yearly smears.
If any further abnormalities are detected on your tests you will be invited to have a further colposcopy examination. There is no evidence that the flow during your period is increased or that the regularity of your cycle is altered by treatment.
Rarely periods may disappear particularly after a cone biopsy this is the treatment that is usually performed with a general anaesthetic but this is due to a rare complication called cervical stenosis, where the cervix becomes blocked and cramp like period pains, continue because of blood becoming trapped in the uterus or womb.
This can usually be dealt with by a procedure to open the cervix and release the trapped blood. Sometimes a smear result will come back as atypical glandular cells and the following is an explanation of this. Abnormalities can occur in both groups of cells but are much commoner in the outer or squamous cells called dyskaryosis on smear and CIN on a tissue biopsy.
In the event of having an abnormality in the glandular cells on a smear test called Atypical Glandular cells on smear , you will be referred either directly by the Laboratory or your smear taker to the Colposcopy clinic. The colposcopist will perform a colposcopic examination and may or may not perform a biopsy at the time. They may also suggest an ultrasound scan of the pelvis to look at the uterus womb as abnormal glandular cells may originally come from there.
Colposcopy assessment is more difficult with atypical glandular cells as sometimes, the abnormality is hidden deep in the tissue or higher up the cervical canal and can be difficult to diagnose.
If they confirm the diagnosis, you will usually be offered a treatment. The treatment can be undertaken as an out-patient procedure, but sometimes the Colposcopist suggests this is undertaken under general anaesthesia and they may consider performing a hysteroscopy [looking at the inside of the uterus womb with a telescope] as well in order to check that this is healthy. You will be told how your results will be sent to you and you may be asked to return for a follow-up discussion.
If the histology tissue removed from the cervix shows CGIN cervical glandular intraepithelial neoplasia , then if you still wish to have children, you will have regular follow-up in the Colposcopy clinic.
Women who have had treatment for glandular abnormalities will not be part of the new follow-up after treatment HPV test, as this may not always be as accurate as in those with follow-up after treatment of squamous abnormalities.
This will depend on the smear test result. If you have had just one abnormal smear with a low grade abnormality it might get better by itself and colposcopy might not be necessary - you will simply need to have the smear test repeated three months following the pregnancy. It is important to remember that pregnancy has no adverse effect in the progression of abnormal cells CIN or the development of cervical cancer.
If a colposcopy has been recommended and an appointment has been made with a colposcopy clinic then you should attend. Colposcopy will not in any way harm the pregnancy and can provide valuable and reassuring information.
In many cases treatment and even biopsy can be deferred until after the pregnancy. It is very important though, to follow through with the suggested plan, to make sure you return to having normal smear tests. Treatment for cervical cancer depends on the stage where the cells are located.
Treatment for early stage cervical cancer is likely to be with loop excision. Cancer may or may not have been suspected from your cervical smear or colposcopy, but the colposcopist will call you back to clinic and explain the findings.
Sometimes no further treatment is necessary but the microscopic findings will be confirmed at a meeting of specialists called a multisciplinary team or MDT meeting. Your specialist will discuss the findings of this meeting with you.
You may be referred to a cancer specialist or gynaecological oncologist at another hospital. They may wish to perform an MRI scan, before deciding if you need further treatment. The pelvic lymph glands or lymph nodes that normally deal with infection can be a site of spread or metastatic disease and sometimes your surgeon will recommend that these should be removed with an operation called a lymphadenectomy. This can be performed as a laparoscopic or keyhole procedure. If you wish to have children, a radical trachelectomy may be discussed with you if this is a suitable alternative for treatment.
The cervix is removed either from the vagina or using an abdominal scar and the pelvic lymph nodes are removed. A stitch is placed around the cervix to help support it during a pregnancy, but your surgeon will warn you that late miscarriage and premature delivery are possible and delivery of your baby would have to be by Caesarean Section. The microscopic appearance of the tumour will be examined whilst you are asleep and sometimes the surgeon will need to proceed immediately to hysterectomy despite any earlier plans.
This is discussed with you before undergoing the operation. A radical hysterectomy may be discussed from the outset again depending on the stage.
Pelvic radiotherapy or chemoradiotherapy is usually offered for more advanced disease and may be offered at a different hospital again. This would be discussed with your cancer surgeon or clinical oncologist radiotherapy doctor.
Radiotherapy or chemoradiotherapy may also be offered following surgery if risk factors are identified in the microscopic report that indicate you are at increased risk of the tumour recurring. This is called adjuvant treatment and is discussed by the specialists at their cancer MDT meeting. Occasionally chemotherapy may be offered before, following or in place of surgery and this depends upon the tumour type on microscopic examination of the initial biopsy.
Again this would be discussed with you by your cancer team. Cervical cancer is now uncommon in the UK as a result of the cervical screening programme. The single most important risk factor for developing cervical cancer is infection with human papillomavirus HPV.
This is a tiny virus which infects skin or mucosa. There are over different types of HPV. They infect only humans and different types infect only specific sites e. HPV is a very common sexually transmitted infection but it is usually only transient. It may be done if a cervical screening test smear test finds that you have abnormal cells in your cervix. These cell changes often go away on their own. But sometimes there's a risk they could turn into cervical cancer if you do not have treatment.
A colposcopy helps your doctor or nurse to confirm if cells in your cervix are abnormal. It also helps them decide if you need treatment to remove the cells. If it's obvious that you have abnormal cells, you may have treatment to remove the cells at the same time as your examination. If it's not clear if you have abnormal cells, a biopsy sample may be taken and sent to a lab.
You'll need to wait until you get your biopsy results to have treatment. Try not to worry if you are told you will need to have a colposcopy. It's very unlikely you have cancer. If you cannot attend, please let the colposcopy clinic know. They will reschedule your appointment. There are 15 colposcopy clinics in Ireland that CervicalCheck use.
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