It is extremely important that you attend your follow-up appointment as advised by your local service. Six months after your treatment you will be called back to have a repeat cervical screening test – this can be done at your GP surgery or in a cervical screening clinic at the hospital where you had your treatment (your colposcopy department will advise you).
Approximately 18–20% of women will test positive for a high risk HPV infection after treatment, as it takes some women longer to clear HPV than others, but only between 5 and 15% of women continue to have cervical abnormalities after treatment. Occasionally second and third treatments are required. It is very important that you attend treatment if further treatment is advised . For more information about recurrent abnormalities, please visit our information page.
Test of cure
In most parts of the UK an HPV test is included as part of the screening test after treatment. This HPV test is referred to as a 'test of cure'. These follow-up tests help to identify if the treatment has been successful, the abnormal cervical cells have been removed and the area is now back to normal.
Test of cure is available across all UK countries. It uses HPV testing to identify if a woman has been successfully cured after treatment for abnormal cervical cells. It tests for high risk HPV, which can cause cervical cancer. Test of cure will only be given to women who have undergone treatment for cervical abnormalities. The test is used in combination with cervical screening cytology (looking at the cells under the microscope).
If high risk HPV is not found (negative test result) and your screening test comes back negative (that means the cells appear normal under the microscope), then you have been successfully treated by removing the abnormal cells and you will be returned to your regular screening schedules. You do not need to have another cervical screening test for three or five years depending on your age or upon your country’s screening programme. The HPV test helps to confirm that there is no longer a higher than average risk of developing further cervical abnormalities.
In Scotland, Northern Ireland and Wales test of cure is currently only done if the abnormality treated was CIN, rather than CGIN. This is because CGIN is much rarer than CIN, so there has been less evidence that test of cure can accurately identify if treatment for CGIN has been effective. However, in March 2016 the NHS Cervical Screening Program in England published new guidelines that test of cure will now be carried out after treatment for CGIN in England. The test of cure will be done six months after the treatment for CGIN. If it is negative for high risk HPV and there are no abnormalities seen under the microscope (negative cytology) then the test of cure will be redone again in another 12 months (18 months after the treatment was done). If this test is negative for high risk HPV and cytology then you will be returned to your regular screening program .
If a high risk HPV infection is found for either CIN or CGIN (HPV positive), or the screening test shows an abnormality you will again be referred to colposcopy for further investigation. If this happens please try not to be alarmed, it is better to get things checked out. Occasionally cervical abnormalities are not fully removed at the first treatment. This is because the treatment needs to balance removing all of the area of abnormal cells as well as saving as much of the normal cervix as possible. This is important because the cervix plays a vital role in pregnancy. If there are still abnormal cells left at follow-up, further treatments can always be done to remove them.
Using both a cervical screening test and the HPV test of cure provides a more effective way of assessing the success of treatment than a cervical screening test alone would. Many women who come back to the colposcopy clinic do not need further treatment.
There is also a small chance that cervical abnormalities may come back in the future. It is therefore really important to keep going for your cervical screening when invited, so that you can have further treatment if necessary.
Remember if you have been found positive for abnormal cervical cells this is unlikely to be cervical cancer. Treatment for abnormal cervical cells is usually very effective and it is estimated that early detection and treatment can prevent up to 75% of cervical cancers from developing .
- Kitchener HC et al., 2008. HPV testing as an adjunct to cytology in the follow-up of women treated for cervical intraepithelial neoplasia. BJOG: An International Journal of Obstetrics & Gynaecology 115(8), 1001–1007.
- Public Health England, 2016. NHS Cervical Screening Programme. Colposcopy and Programme Management (Third Edition). https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil.... Accessed: 12.04.2016.
- Peto et al., 2004. The cervical cancer epidemic that screening has prevented in the UK. Lancet 35, 249–256.