Colposcopy FAQs

Like cervical screening, colposcopy is a test to help prevent cancer. It examines in a more detailed way any cells that look abnormal at screening. If abnormal cells are confirmed at colposcopy, they can be treated long before they become cancerous.  

Another reason someone may be referred for colposcopy is if cervical screening hasn’t been able to give a clear result, for example, because insufficient cells were collected. 

A patient may also be invited for colposcopy if their cervix didn’t look as healthy as it should at screening, or if they have symptoms such as abnormal vaginal bleeding.  

It’s very rare for cancer to be found at colposcopy.  But this is more likely to happen if someone doesn’t attend regular cervical screening, one of the best ways to prevent cancer. So it’s important to help your patients make an informed decision about attending screening appointments – you can read more in our cervical screening section.

This can be very confusing for patients but the two procedures are different tests, looking for different things. 

Cervical screening looks for human papillomavirus (HPV) and/or evidence of abnormalities in cells. It’s a snapshot of the health of cervical cells and indicates whether more testing is needed. 

Colposcopy looks more closely at the cervix. It can confirm whether there are any abnormal cells and whether these need to be treated. So a patient may have an abnormal screening result but at colposcopy may be told their cervix is healthy. Around 4 in 10 have a normal result at colposcopy.  

An inadequate result doesn’t mean cells are abnormal. It can happen for a number of reasons. For example, it may have been difficult to obtain enough cells, or blood in the sample may have obscured cells. If this happens several times, someone will be referred for colposcopy. The colposcopist has specialised equipment to help them look in detail at the cervix and take another sample of cells, so a clear result can usually be given.  

Sometimes, the colposcopist needs more information about cells that look abnormal. They will take a small sample of tissue from the cervix to be tested. This is usually described as feeling like a pinch. A biopsy can help doctors work out the risk of abnormal cells becoming cancerous in future. Often, cell changes go back to normal and treatment would be unnecessary. Information from a biopsy can give doctors and patients the information they need to make a decision together.  

In the 24 hours before the appointment, they should avoid having sex or using anything inside the vagina. That includes medications, lubricants, tampons and menstrual cups. You could advise patients to take a sanitary pad or panty liner with them, as they may have some light bleeding or discharge afterwards.

Colposcopy is safe during pregnancy but if a biopsy or treatment is needed, a patient will usually be advised to wait and have those after the birth. The procedure isn’t usually carried out during a period, simply because the blood can make it harder for the colposcopist to see the cervix. However, if bleeding’s light, it can usually still be done. The patient should contact the clinic for advice if they’re expecting a period around the time of the appointment. 

Yes. An examination can be carried out while someone’s wearing their coil. If a biopsy and/or treatment are needed, a colposcopist will usually be able to carry that out around the coil. 

It feels very similar to cervical screening. For most women and people with a cervix, that means it’s uncomfortable but not usually painful. There may be some discomfort when the colposcopist inserts the speculum and opens the cervix, and sometimes the liquids used to stain the cells may cause mild stinging or tingling. The procedure is over very quickly. 

However, just like screening, colposcopy can be painful for some. You can help by encouraging patients to talk about their past experiences with cervical screening so the colposcopist knows they’ve found similar procedures difficult, and can take extra steps to help. 

It’s worth noting some women and people with a cervix find colposcopy can actually be more comfortable than routine screening. Colposcopists are highly trained and experienced and have specialised equipment that may help make the procedure more straightforward. 

There are different possibilities, based on results:

• If the result is normal, there’ll be no follow-up appointment and the patient will be discharged back to the routine cervical screening programme.
• If results show low-grade cell changes, known as CIN1, a patient will usually be asked to go for cervical screening in 12 months. It’s important to explain to patients it isn’t a routine screening appointment. It’s colposcopy follow-up and is known as conservative management. It’s often suggested because the cell changes are likely to go back to normal. But sometimes, the colposcopist will advise treating these abnormalities. It depends on the patient’s individual case.
• If results show higher grade cell changes, someone may be advised to return for treatment to remove these abnormal cells and prevent them becoming cancerous in future. 

Being discharged back to routine screening or asked to go for screening in 12 months can seem positive. But sometimes, having no ’formal’ follow-up appointment can cause a lot of anxiety in women and people with a cervix. 

The screening will look for HPV (other than in Northern Ireland) and this can cause worry for someone who’s had cell changes. It may not seem enough. They may worry about what’s going on inside their body. They might wonder whether something has been missed, or they may feel concerned any mild cell changes are progressing. Encourage them to talk about their concerns. You could suggest they call our Helpline if they’re worried on 0808 802 8000.

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it. 

References

• NHS. Colposcopy – treatment. Found at: https://www.nhs.uk/conditions/colposcopy/treatment/
•   NHS. Colposcopy. Found at: https://www.nhs.uk/conditions/colposcopy/
•   NHS Cervical Cancer: Diagnosis Found at: https://www.nhs.uk/conditions/cervical-cancer/diagnosis/
•   NHS. Colposcopy – results. Found at: https://www.nhs.uk/conditions/colposcopy/results/
•   BSCCP. FAQs. Found at: https://www.bsccp.org.uk/women/frequently-asked-questions
•   NHS. Colposcopy – results. Found at: https://www.nhs.uk/conditions/colposcopy/results/
•   NHS Colposcopy – what happens. Found at: https://www.nhs.uk/conditions/colposcopy/what-happens/
•   BSCCP. FAQs. Found at: https://www.bsccp.org.uk/women/frequently-asked-questions

We write our information based on literature searches and expert review. For more information about the references we used, please contact info@jostrust.org.uk

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