Frequently asked questions on the results of abnormal cervical cells and treatments
This page is a selection of different questions that Jo’s Cervical Cancer Trust has received about cervical screening. The answers have been reviewed by Jo’s Cervical Cancer Trusts medical advisers.
I’ve received an abnormal screening result, what happens next?
This will depend on the abnormality. Usually borderline and mild dyskaryosis (CIN 1) will not require treatment; instead close monitoring, either with a repeat screening in 6 months or with referral to a colposcopy clinic. Moderate and severe dyskaryosis (CIN2 and CIN 3) will require further investigation at a colposcopy clinic and may require treatment.
Some hospitals have a longer waiting list for treatments than others. If you are concerned about the timing of your appointment (short or long) do speak to your doctor.
My colposcopy results showed that I have CIN, do I have cervical cancer?
No. If your results show you have cervical intraepithelial neoplasia (CIN) this means that you have abnormal/pre-cancerous changes to cells in your cervix. These changes are not cancerous but without treatment these cells could change into cancerous cells.
If CIN is not cancer, why do I have to have treatment?
Although CIN is not a cancer, the reason treatment is offered is to reduce the risk of a cancer developing in the future. Research has shown that changes in abnormalities do not usually escalate quickly and it can take between 10 to 15 years for a cancer to develop.
What are the symptoms of CIN?
CIN do not cause symptoms - no pain, no discharge and no bleeding. This is why it is important for you to attend your invitation for a smear test or to see your doctor if you experience any or all of these symptoms.
How is CIN/CGIN treated?
If your cervical screening result is abnormal you may be required to attend an outpatient colposcopy clinic where your cervix can be examined more closely. It is important to remember, however, that abnormal cells can be treated. Treatment is usually given as an outpatient. CIN & CGIN are largely treated in the same way
Treatment of CIN can be dependent on:
- The grade and size of abnormality diagnosed
- Your choice of treatment options
- Your colposcopists preference
- Your age.
The main treatments (if advised) for CIN are either to eradicate the abnormal cells or remove the area of abnormality and 95% to 98% of women are cured after one treatment. Between 2% and 5% of women do have recurrence of abnormalities, which will require further treatment.
The main treatments for CIN/CGIN are:
- removal of abnormal area, using either large loop excision of the transformation zone (LLETZ), cone biopsy, laser therapy, or cryotherapy
- a hysterectomy but this is very rare
Once you are sufficiently recovered (your consultant will advise you), none of these treatments should interfere with your sex life.
I'm pregnant and just found out that I have an abnormal screening result, what do I do?
You should seek advice from your doctor. They will often ask to you to undergo a colposcopy examination to properly assess the change on the cervix so that they can advise with regard to any treatment that may be required. A colposcopy examination will not cause any risk to the pregnancy. If you are asked to attend a colposcopy examination do remember to tell your colposcopist that you are pregnant just in case they are not aware.
Colposcopy and punch biopsy
What is a punch biopsy?
A punch biopsy is a small sample of the cervix that is taken at the time of a colposcopy examination, usually after the application of solutions to the cervix (used to highlight the abnormal area or areas). More than one punch biopsy may be taken. It is purely for diagnostic purposes. The biopsy is sent to the histopathology department who will report on the type of abnormality present. Some women do not feel anything when a punch biopsy is taken while others experience a little discomfort (tenderness or an ache) during and/or after the biopsy. You may experience a small amount of bleeding and/or discharge for a few days following a punch biopsy.
Is it possible to see if I have cancer during colposcopy?
Not necessarily - it will depend on the size, position and appearance of any abnormality seen. All abnormal areas should be biopsied and sent for microscopic examination to detect the level of abnormality and if cancer is present.
Is there a link between the abnormality suggested by the cervical screening result and the appearances seen through the colposcope?
Yes. If there is any doubt a small biopsy can be taken from the most affected area for analysis.
What happens if I have an obvious abnormality at colposcopy or a positive biopsy result?
Women who have an obvious abnormality at colposcopy or a positive biopsy result will proceed to treatment. The most common form of treatment is called LLETZ (Large Loop Excision of the Transformation Zone) in the UK, and LEEP (Loop Electro-Excision Procedure) elsewhere.
Is laser treatment also used to remove abnormal cells from the cervix? Why is LLETZ/LEEP treatment now more popular?
Before the introduction of the LLETZ treatment in the early 1990's, laser treatment was the preferred method to remove pre-cancerous cells from the cervix. After confirming the presence of CIN with a small punch biopsy, a laser beam (high-energy light) was used to vaporise the abnormal area, or the laser beam was used to cut a cone of tissue out similar to the LLETZ/LEEP procedure. Tissue healing after laser treatment was very good. However, laser treatment has largely been replaced by the LLETZ/LEEP. Whereas the equipment for LLETZ/LEEP is much cheaper to buy, use and easier to maintain than laser generators, it is the safety aspect of sending a large amount of tissue for pathological analysis after a LLETZ/LEEP procedure to ensure that a small, invasive cancer has not been missed which attracts gynaecologists to favour LLETZ/LEEP over small biopsy/laser.
Last updated: 07/10/2011
