Getting an abnormal smear test result – What to do next

Abnormal Smear Test? Mr Sotiris Vimplis, Consultant Gynaecologist Explains Why You May Need a Colposcopy

Mr Vimplis holds clinics at The Holly on Monday evenings and on alternate Wednesdays.
To book an appointment call our friendly appointments team on 020 8936 1201.  

Cervical cancer kills approximately 285, 000 women every year around the world. More than 80% of these deaths occur in under-resourced countries. In contrast, cervical cancer deaths are now low in developed countries and have been reduced by 90% following the introduction of cervical screening programmes, demonstrating that the disease is potentially preventable.

Cervical cancer stats in the UK: 

• 3,224 new cases of cervical cancer, 2014, UK
• 890 deaths from cervical cancer, 2014, UK
• 63% of women survive cervical cancer for 10 or more years, 2010-11, England & Wales
• 100% preventable cases of cervical cancer in the UK

* Taken from www.cancerresearchuk.org/

Being screened regularly means that any abnormal changes in the cells of the cervix can be identified at an early stage and treated before cancer develops.

What is HPV?
HPV is the name of a family of common viruses that affect the skin and the mucus membranes (moist tissue that lines parts of the body), such as those in your cervix, anus, mouth and throat. The types of HPV that can cause abnormalities of the cervix are transmitted through sexual contact.

In the UK, it is estimated that 8 out of 10 people are infected with HPV at some point in their lifetime. In the majority of cases, the individual’s own immune system clears the infection within two years. However, if infection with some types of HPV persists, it can cause abnormal cell growth, which can lead to cervical cancer.

My smear test is abnormal – what does this mean?
A smear test is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. Most women’s test result is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

I’ve been advised I need a colposcopy. What is a colposcopy?
Colposcopy is simply a more detailed look at the cervix. Instead of looking at the cervix with the naked eye, a special microscope is used to check for changes at high magnification with good lighting.

What will happen if I book a colposcopy at The Holly?
First of all, you will be seen by friendly staff who are dedicated to this clinic. They will understand that you may be worried and will take time to discuss your cervical smear result before the examination. You will be examined on a purpose-built couch. A speculum (the instrument needed for your smear to be taken) is used to visualise the cervix which is then examined with the colposcope. The doctor will put a number of different solutions on the cervix and look for changes that indicate the presence or otherwise of pre-cancerous changes.

To be sure of the diagnosis, a biopsy is often required – this means taking a small sample of tissue from the cervix with a special instrument. You will be told there and then if there is any abnormal area and might even be shown a picture of the problem area.

Will I need treatment?
Many women will not need further treatment but some women will. You may have heard of ‘loop treatment’ as this is the commonest way of treating CIN today. This can usually be performed under local anaesthetic to ‘numb’ the cervix.  The abnormal area is removed using a wire loop through which an electric current is passed. These treatments are simple and relatively easy and most importantly very effective at getting rid of the problem and returning you to normal tests.

What follow-up is needed?
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.

Should I be worried about cancer?
Whilst about 1 in 20 women will have a smear test result which is abnormal, only about 1 in 2000 will have cervical cancer. That means approximately 1% of women with any grade of abnormal smear will have a cancer. So statistically speaking the risk that you have already developed cervical cancer at the time you are seen in colposcopy clinic is very small even if your smear is abnormal.
We realise 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.

Making an appointment 
Mr Vimplis holds clinics at The Holly on Monday evenings and on alternate Wednesdays. An initial consultation costs around £200 with follow-up appointments costing approximately £150. Any treatments will be charged separately.

To book an appointment call our friendly appointments team on 020 8936 1201.