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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