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If cell changes (abnormal cells) come back
Sometimes cell changes (abnormal cells) come back after treatment. These are also called persistent or recurrent cell changes.
Finding out that cell changes have come back can be tough. You may have questions about your future health, worry about the next steps, or simply feel upset that you have to go through this again. Remember, however you feel, we are here for you. You might want to call our Helpline on 0808 802 8000 or join our forum to chat with those who’ve been through something similar.
Why do cell changes (abnormal cells) come back?
After treatment for cell changes:
- about 9 in 10 (90%) people will not have further problems
- fewer than 2 in 10 (between 5% and 15%) people may have cell changes that come back.
Cell changes may come back if we have a virus called human papillomavirus (HPV). It’s a common virus that most of us will get at some point in our lives. There are over 200 HPV types, including some that can cause cell changes in the cervix. We call these types high-risk HPV.
Most of us will get rid of HPV without it causing cell changes or needing treatment, but some people find it harder to clear. At the moment, no one knows why this is.
What happens if cell changes (abnormal cells) come back?
Cell changes coming back can be worrying, but try to remember:
- it does not mean you will develop cervical cancer
- they can be managed with monitoring or treatment.
However, even knowing this, you may feel upset or angry about going through tests and possibly treatment again. It is common to feel this way and we, along with your healthcare team, will do everything we can to support you:
- Our Helpline volunteers all have personal experience, so call them on 0808 802 8000 and talk with someone who gets it. Check our Helpline opening hours >
- Connect with others going through something similar on our online Forum >
- If you have a medical question, try our Ask the Expert service >
If cell changes come back, they are usually found after your follow-up appointment.
Read more about follow-up after treatment for cell changes >
If your cervical screening (smear test) done during this appointment finds high-risk HPV, you will be invited to colposcopy again. The appointment will be the same as your first one.
Read about what happens at colposcopy >
You will have another biopsy:
- If you have low-grade cell changes (CIN1), you may not need treatment and will be invited for another follow-up appointment in 12 months.
- If you have high-grade cell changes (CIN2, CIN3 or CGIN), you may need further treatment.
Read more about CIN and CGIN >
Treating cell changes (abnormal cells) that have come back
You will usually be offered a large loop excision of the transformation zone (LLETZ). This treatment removes the affected area.
Depending on your situation, you may be offered a different kind of treatment. Your colposcopist will talk through all the treatment options with you.
Read more about treatments for cell changes >
If cell changes come back more than once
If cell changes come back more than once, you may be offered a hysterectomy. Your colposcopist will only offer this if:
- they think there is a high risk the cell changes may develop into cervical cancer in future
- it is not possible to safely do another LLETZ.
Read more about hysterectomy >
As with any treatment, your colposcopist or doctor will talk through the treatment with you. You can discuss things that are important to you, like whether you have had any children you want or been through menopause.
Some people choose to have a hysterectomy so they can be certain all the cell changes are gone. If you have a hysterectomy for this reason, you can usually keep your ovaries, so it won’t affect your hormones or trigger an early menopause.
Side effects and possible risks of treatment
Before offering you further treatment, your colposcopist will think about any possible risks of multiple treatments. They should discuss these with you, so you can be involved in making decisions about treatment.
If you have had treatment before, any risks are usually the same as they were after that treatment. However, there may be a slightly increased risk of giving birth early (premature birth), as more of your cervix may be removed.
Read more about risks of different treatments for cell changes >
Reducing your risk of cell changes (abnormal cells) coming back
Sometimes, our immune system just has a harder time getting rid of HPV and there is not much we can do about it. But, for some people, there are lifestyle changes that may reduce the risk of cell changes coming back.
Stop smoking
If you smoke, you may want to try to stop. Smoking makes your immune system weaker, which may mean:
- it is less likely to get rid of high-risk HPV
- cell changes infected with HPV are more likely to progress to cancer cells.
About 2 in 10 (21%) cervical cancers are linked to smoking. The risk is higher for current smokers, who have almost double (46%) the risk of developing cervical cancer. This means their overall risk of developing cervical cancer is between 2% to 4%.
Stopping smoking can be hard, especially if you are already struggling with cell changes or treatment. But if you want to stop, support is available:
- If you live in England, visit Smokefree >
- If you live in Scotland, visit Quit Your Way >
- If you live in Wales, visit Help Me Quit >
- If you live in Northern Ireland, visit Stop Smoking NI >
More information about cell changes (abnormal cells) that come back
If you want to understand more about why cell changes come back, try our confidential online Ask the Expert service. Our panel of medical experts can answer your questions and offer some reassurance.
Use our Ask the Expert service >
Sometimes the most helpful thing is talking to someone who gets it. Our Helpline volunteers all have personal or professional experience of cell changes or cervical cancer, so know what you’re going through. Call us on 0808 802 8000.
Check our Helpline opening hours >
If talking on the phone isn’t for you, our online Forum may suit you better. It’s a safe space to connect with others going through similar experiences, get support, or simply read what others have to say.
- Onuki M. et al, Posttreatment human papillomavirus testing for residual or recurrent high-grade cervical intraepithelial neoplasia: a pooled analysis, Journal of Gynaecological Oncology, 2016.
- Cancer Research UK, Cervical Cancer Risk, www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/risk-factors Accessed: February 2019.
- International Collaboration of Epidemiological Studies of Cervical Cancer: Appleby P. et al, Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies, International Journal of Cancer, 2006.
- NHS Inform, Colposcopy - Tests & treatments www.nhsinform.scot/tests-and-treatments/non-surgical-procedures/colposcopy Accessed: June 2019.
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Date last updated:
24 May 2019
Date due for review:
23 May 2022