The first thing to say is that the vast majority of women in your situation do not have cancer but a condition with changes in the neck of the womb cervix that we call CIN. When these changes are found it is normally very easy to get rid of them completely.
We hope to give you all the information you need in this section. You may be asked to attend a colposcopy clinic see what is colposcopy and an information leaflet may be enclosed with your appointment.
You should arrange a convenient appointment time to attend your clinic but still take the opportunity to discuss the findings of the smear with your GP or practice nurse. Pre-cancerous changes of the outer squamous cells of the cervix are those that have the potential to turn into cancer if left untreated for some time. This rather long term means that the changes are confined to the outermost surface of the cervix and there has been no spread of disease.
The risk of developing cancer is related to the grade of CIN. We know that most cases of CIN1 will go back to normal without any treatment. The risk of CIN1 developing into cancer is very small. There is no evidence that daughters and other female relatives of women with abnormal smears, pre-cancerous cells CIN or cervical cancer have an increased risk of abnormal smears, pre-cancerous cells or cervical cancer.
Cervical smear abnormalities are common and it is not unusual for one or more family members to have had an abnormal smear, but there is no inherited predisposition to cervical abnormalities, CIN or cervical cancer.
Your smear has been called inadequate. There may be many reasons for this. It is not the fault of the person who took your smear but for one reason or another the process required to produce a sample for the cytologist who reads your smear has been unable to provide a satisfactory specimen. There can be many reasons why; from a simple problem like difficulty in obtaining enough cells for the laboratory to read or too much blood on the smear or a more complex difficulty in the preparation process.
Sometimes your doctor or practice nurse can advise a treatment that may make taking a further sample more effective, such as vaginal oestrogen cream if the inadequate smear is due to postmenopausal changes in the cervix or antibiotics if infection is present. Importantly an inadequate smear does not mean your smear was abnormal but that it was unreadable. This is an inconvenience but should not make you worry. Ask your doctor or practice nurse why your smear was inadequate and be aware that you will be called for a repeat cervical cytology sample in three months.
Waiting for this time before repeating the test, reduces the risk of a further inadequate sample. The new smear taking technique called liquid based cytology has made this problem less likely but occasionally women may be referred to colposcopy clinic if the problem persists see what is colposcopy.
Borderline change requires a colposcopy appointment see what is colposcopy only if the abnormality remains after repeat testing and usually after such smears taken at 6 monthly intervals, because the risk of a pre-cancerous abnormality here is very small. The reason for this is that a lot of minor smear abnormalities go back to normal after several months. If the smear shows mild changes you may be referred to colposcopy clinic or asked to have another smear in 6 months and then referred to colposcopy clinic only if the abnormality persists.
If the changes are more abnormal then referral is made without the need for a further smear. Whilst about 1 in 20 women will have a smear test result which is abnormal, only about 1 in will have cervical cancer. So statistically speaking the risk that you have already developed cervical cancer is very small even if your smear is abnormal. We realize though that women worry about this possibility and this is where colposcopy is really helpful.
In the majority of women the colposcopy is really reassuring as it shows more clearly what the situation is. So the advice is if you have been referred to colposcopy it is important that you keep your appointment.
You will be told there and then whether there is any abnormal area and might even be shown a picture of the problem area if you like. Many women will not need further treatment but some women will. These treatments are simple and relatively easy and most importantly very effective at getting rid of the problem and returning you to normal tests. These are in fact a large family of viruses, only a few of which are involved in causing abnormalities of the cervix and lower genital tract.
Of the over HPV viruses, the main types responsible for changes to the cervix are types 16,18,31,33 and While it is true that virtually all women with CIN and cervical cancer have had HPV infection, so have a huge number of other people without disease.
About 4 out of 5 adult men and women have had HPV infection at some time in their lives, but only a small minority of women with an HPV infection ultimately have an abnormal smear and a tiny fraction of these get cervical cancer.
It is acquired or caught in almost all cases through close intimate or sexual contact, but the infection is so common and so subtle that referral to a sexually transmitted disease clinic is not appropriate. Certainly no antibiotics or other treatment for HPV infection is required. HPV only causes cervical smear abnormalities if it is not cleared from the body over a period of years. The smear abnormality requires further examination and sampling and sometimes treatment in colposcopy clinic. Within the next year, a test for HPV infection when borderline and mild smear abnormalities are reported will be part of routine practice in England.
Immunisation against HPV started in September for girls aged 12 to 13 with a catch up for girls up to 18 in the following 3 years. It is however, unlikely to alter the rates of smear abnormalities for many years. You should be aware that smoking can make clearing HPV from the body less effective and can make clearance of minor smear abnormalities slower and less efficient.
For this reason stopping smoking may be advised by your GP, practice nurse or staff in the colposcopy clinic. The combined oral contraceptive pill is associated with a very slightly increased risk of cervical cancer. A recent series of publications found this to be in women that have HPV.
This is not very helpful, as HPV almost always has no symptoms except rarely causing genital warts due to some types of HPV and most adults at some stage of their lives do have HPV, although in most cases the infection is short lasting a matter of months.
Family planning doctors strongly recommend that women requiring contraception should use a reliable method. The combined pill is a good method of contraception. If you have an abnormal smear and are taking the combined pill, you should continue to take the pill.
It has no effect on making any changes occur any faster. Colposcopy is simply a more detailed examination of the cervix. Instead of looking at the cervix with the naked eye, [as when your practice nurse or GP took your cervical sample smear ], we use a special magnifying binoculars to see the changes at high magnification.
The magnifying binoculars stay outside you. All that goes inside is the speculum, which is the instrument your GP or practice nurse used to see your cervix when taking your cervical sample. Some clinics may be equipped with camera equipment so that you can watch the examination if you wish.
Some clinics take a picture for your records and you will be asked beforehand if you are agreeable to this being done. The pictures are helpful for comparison, if you have to return for a repeat examination. The examination may take a little longer than a standard smear test, but the doctor or nurse performing the colposcopy will talk to you, before and during the examination and tell you what is being done.
Sometimes the threads are inadvertently cut but this is not a problem as a coil can be removed when you no longer wish to use it without the threads. You should have the chance to discuss your smear abnormality with your GP or practice nurse. If an appointment is needed at the colposcopy clinic, then this will be sent to you or your GP will send to letter to the clinic.
In some places, however, you may receive an appointment directly from the Colposcopy clinic, as they will have been informed of your abnormal smear result, directly by the laboratory.
You should then confirm the appointment with the clinic at a convenient time for you. Whatever the kind of smear abnormality you have, if you are referred for colposcopy you should not have to wait long for the appointment. The vast majority of women referred for colposcopy should be seen within 8 weeks. First of all you will be seen by friendly staff who are dedicated to this clinic.
They will understand how you may be worried and will take time to discuss your cervical sample smear result before the examination.
You will be examined on a purpose-built couch. The cervix is viewed using a speculum the instrument needed for your smear to be taken and then examined with the colposcope at low magnification times magnification. The doctor or nurse will put a number of different solutions on the cervix and look for changes that indicate the presence or otherwise of pre-cancerous changes or CIN. Acetic acid dilute vinegar is applied to the cervix using a cotton wool ball or by a spray.
Abnormal areas such as CIN will tend to turn white acetowhite. The exact reason why CIN tissue turns white with acetic acid is not fully understood. Also it is important to say that some areas of acetowhite do not indicate CIN at all.
One of the challenges facing the colposcopist is to decide which areas of acetowhite truly represent pre-malignancy and to avoid treating minor conditions. The colposcopist may use another test using an iodine solution. Normal tissue on the outside of the cervix stains dark brown when iodine is applied. On the other hand, pre-cancerous abnormalities may not stain with iodine. The cells on the inner part of the cervix also do not stain brown.
This test may be used following acetic acid colposcopy and is often used before treatment. If there is an abnormality the colposcopist should be able to estimate whether it is a likely pre-cancerous abnormality or not according to:.
Already a member? Sign in now. Not a member yet? Register now. Search for discussions or people. Please can someone help I would like to be able to talk to someone if possible? Thanks Catherine. I hope all goes well tomorrow. Wishing you all the best, Ben Cancer Chat Moderator. Thanks Went to hospital 9th March and the doctor I seen did a smear test first then a colposcopy and she said I would have to wait for about 2 weeks just under for my results but unsure what those results will show as I'm guessing the colposcopy is more in depth than a smear test so I hope that my doctor that looked in the colposcopy would have seen if there was any cancer or not.
Show per page: Been to clinic. Bleeding after biopsy. We know that some of these areas can go on to become cancers if left without treatment for months and years. However, many of the abnormalities will go away by themselves without treatment. The next step with an abnormal smear is to have a colposcopy. Does an abnormal smear mean I have a cancer? An abnormal smear reflects changes, just in the skin of the cervix and so are not cancer.
If the changes are ignored over many years they may become a cancer, but when they are first detected by a smear, they are almost always confined to the skin only. Because these changes involve just the skin of the cervix, they are not cancer.
They can change into cancer if left for a number of years but often, these abnormalities will go back to normal without treatment. How is an abnormal smear graded? Abnormal smears are graded as borderline, mild, moderate or severe dyskaryosis depending upon how abnormal the cells appear. Even severe abnormalities only suggest changes that might become a cancer if left for a number of years.
None of these findings suggest the presence of a cancer. The smear test is used as a screening test so the grade of abnormality is assessed better at colposcopy. What is dyskaryosis?
Dyskaryosis is the term used to describe the abnormalities seen within cells in a smear.
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