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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.
After treatment for cell changes:
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.
Cell changes coming back can be worrying, but try to remember:
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:
If cell changes come back, they are usually found after your follow-up appointment.
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:
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.
If cell changes come back more than once, you may be offered a hysterectomy. Your colposcopist will only offer this if:
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.
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.
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.
If you smoke, you may want to try to stop. Smoking makes your immune system weaker, which may mean:
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 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.
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.
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.