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Most of the time, cervical cell changes (abnormal cells) don’t come back after treatment. However, sometimes they do and may need further treatment. These cell changes are also called persistent or recurrent cell changes.
On this page:
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.
Usually, your immune system gets rid of HPV without it causing cell changes, but some people find HPV harder to clear. Sometimes, HPV can stay in the body and cause the cells of the cervix to change.
We know that cell changes coming back can be worrying or upsetting. It may help to try to remember:
Although it may be difficult to go through getting these results and the next steps again, it means your colposcopy team can make sure you get the right care and support.
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 usually have further tests at colposcopy again.
The colposcopy appointment will be the same as your first one.
You will usually have another biopsy (sample of cervical tissue) taken. The result of the biopsy will help to decide what happens next:
As well as the biopsy result, your colposcopy team will look at other things when making a decision about next steps, including:
Lucy, who shared her story with us
Large loop excision of the transformation zone (LLETZ) is the most common treatment offered for cell changes that have come back. This treatment removes the affected area.
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, if you have a treatment that removes some of the cervix such as LLETZ, there may be a slightly increased risk of giving birth early (premature birth), as more of your cervix will be removed .
If cell changes come back more than once, your colposcopy team with talk you through the different options. Usually, treatment will be offered again.
In some cases, you may be offered a hysterectomy for cell changes that keep coming back. Your colposcopy team will only offer this if:
As with any treatment, your colposcopy team or a surgeon will talk through hysterectomy with you. When this happens, it is important that you can discuss things that are important to you, like whether you have had the number of 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 should not affect your hormones or trigger an early menopause.
We have more information about hysterectomy, which you can read by clicking the link below. Please note that this page is written for those having a hysterectomy for cervical cancer, which may be worrying – but remember that cell changes are not cervical cancer.
You may feel a mix of emotions on hearing that cell changes have come back – from relief that they have been found and can to be treated, worry about the next steps, or upset that you have to go through this again . There is no right or wrong way to feel, but it is important that you are able to manage those emotions and get the right support.
Lucy, who shared her story with us
The most common reason for cell changes to come back would be your immune system not getting rid of high-risk HPV. We don’t yet know why some people can clear HPV and others can’t. But going for your follow up appointments helps your colposcopy team keep a close eye on HPV and any cell changes, so they can make sure you get the right care.
Having persistent HPV does not mean you will always have cell changes, or that they will keep 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.
If you smoke, you may want to try to stop. Smoking makes your immune system weaker, which may mean:
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:
We know that having cell changes come back can be confusing and sometimes worrying. Your colposcopy team will be able to help answer any questions, as they know your background and medical history.
We are also here to support you. Our Helpline volunteers all have personal or professional experience of cell changes or cervical cancer, so can empathise with what you’re going through – you can email us or call us on 0808 802 8000.
Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.
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.
We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]