Cancer Screening Programmes

NHS Cancer Screening Programmes .

Cancer Screening Programmes

CERVICAL SCREENING

What your abnormal result means

You have had an abnormal result from your

cervical screening test.

Cervical screening is designed to pick up minor changes before any problems

develop, and almost certainly that is what the test has done for you.

An abnormal result is not unusual: about 1 in 20 women have test results that

show some abnormality.

It is important to remember that it is extremely rare for an abnormality found at

screening to be cancer. Nearly all abnormal results show no more than small

changes in cells. These act as an early warning sign that, over time, cervical

cancer may develop.

What does my result mean?

An abnormal result usually means that small changes have been found in the

cells on the cervix (the neck of the womb). The name given to these changes is

dyskaryosis.

In many cases these changes return to normal by themselves. But sometimes

the changes become worse and could lead to cancer in the future. In such

cases it is necessary to have a further examination which will show if treatment

is needed. Treatment is simple and virtually 100 per cent effective.

Fortunately, it usually takes many years for cancer of the cervix to develop. So it

is very rare, especially in women who have regular cervical screening, for an

abnormal result to show that cancer has already developed.

What causes an abnormal result?

Changes in the cells of the cervix are often associated with the Human

Papilloma Virus (HPV), which is transmitted by sexual intercourse. There are

over 100 types of this virus, and certain types are linked with nearly all cases of

cervical cancer. Most women are infected with HPV at some point in their lives,

but most infections disappear without the need for treatment. Even women with

‘high risk’ HPVs rarely go on to develop cervical cancer.

HPV often shows no symptoms. It is therefore possible that you may have had

the virus for many years without knowing about it, or a partner may have been

infected many years ago and, again, not know.

What happens now?

For many women their abnormal result will show borderline changes or mild

dyskaryosis. These are small changes which often return to normal by

themselves.

The areas of changed cells are known as cervical intraepithelial neoplasia, or

CIN. Mild dyskaryosis is associated with the grade CIN 1.These changes are

not cancer, and in most cases do not lead to cancer in the future.

It is safe to give the small changes a chance to return to normal by themselves

without having immediate treatment. If you have a test result showing borderline

changes or mild dyskaryosis your doctor will often ask you to return for a repeat

screening test in around six months’ time, but you may be referred for

colposcopy (see below).

If the repeat test is normal, you will be asked to have two more tests at six-

monthly intervals to be sure that the cells are still healthy. If they are healthy,

you will then go back to receiving routine screening invitations as before.

If your repeat test still shows borderline changes or mild dyskaryosis, you may

be referred to a clinic for a further examination – called colposcopy.

For some women their result will show moderate or severe dyskaryosis.

These areas of changed cells are associated with the grades CIN 2 and CIN 3.

Even with CIN 2 or CIN 3 grade changes, it is unlikely that you have cancer.

However, these changes are less likely to return to normal by themselves and

usually need treatment. To decide whether you need treatment, a colposcopy

examination will be carried out to investigate the cervix in detail. It is important

that these changes are checked now, in case they become more serious in the

future.

What is colposcopy?

This is a simple examination at a colposcopy clinic that allows the doctor to

decide if you need treatment.

An instrument called a colposcope is used. This is a type of microscope or

magnifying glass which lets the doctor look more closely at the changes on your

cervix. It does not touch you or go inside you. The examination is very similar to

the screening test, so women may find it a bit uncomfortable.

If you need colposcopy, make sure you receive the leaflet Cervical Screening:

The colposcopy examination.

What about treatment?

If you need treatment following colposcopy you will usually by treated as an

outpatient and there will be no need for you to stay in hospital.

Treatment is nearly always 100 per cent successful. The area of changed cells

will be removed from the cervix.

The method for this will vary from clinic to clinic, but it is a simple procedure and

will be carried out under local anaesthetic.

What follow-up will I need?

If you do need treatment, you will be asked to have two follow up screening

tests at around six-monthly intervals afterwards, to check that all the abnormal

cells have been removed. If these check ups are normal, you will be advised to

have tests every year for up to nine years. Assuming no further problems occur

in that time, you will then go back to your usual screening interval of once every

three to five years (depending on your age).

What about sex?

Sex does not make any abnormality worse, and you cannot pass on abnormal

cells to your partner. Enjoy sex as usual, but you should use an effective

contraceptive.

It is important not to get pregnant until your abnormality is dealt with, as the

hormones produced during pregnancy make treatment more difficult.

Colposcopy will have no effect on your future fertility. The colposcopist will

discuss with you the possible effect that treatment may have if you become

pregnant in the future. Pregnant women needing treatment may be advised to

wait until after the birth of their baby.

Further information

If you have any questions regarding your condition or if you feel worried at all,

do not hesitate to phone or make an appointment with your GP, who will be

happy to talk to you.

Summary

- About 1 in 20 women have an abnormal cervical screening result, so it is

not particularly unusual

- Nearly all abnormal tests show no more than small changes in the cells

on the cervix. These changes would probably never develop into cancer,

but it is sensible to monitor them

- Treatment, if needed, is simple and virtually 100 per cent effective. You

will usually be treated as an out patient. The colposcopist will discuss

any effects treatment may have on pregnancy

- You can have sex again within a few weeks of treatment

- Having an abnormal screening result does not affect your ability to

have children.

Cancer Screening Programmes

Published by the Department of Health in association with NHS Cancer

Screening Programmes and Cancer Research UK

© Crown copyright 2006

Produced by COI for the Department of Health

Last updated 2006

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