Colposcopy is an examination of the cervix by the microscope. It is a simple procedure, which involves inserting a speculum for an internal examination. A diluted solution of acetic acid is applied and the cervix is examined for white areas. It is usually associated with the discomfort encountered during a smear test and takes only 5 minutes to complete. A biopsy may be taken from these areas (slightly more painful) and sent for further testing in the laboratory. Although the consultant will be able to give you some idea, however the final outcome can only be obtained after the biopsy results.
Cervical screening is designed to pick up minor changes before any problems develop. If you have had an abnormal result from your cervical screening test (your smear test) it is important to remember that it is extremely rare for these abnormalities to be cancer.
An abnormal result is not unusual: about one in ten women have test results that show some abnormality.
Nearly all abnormal smears show no more than small changes in the cells on the cervix (the neck of the womb). The name given to these changes is dyskaryosis. These changes act as an early warning sign that, over time, cervical cancer may develop.
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 could show that 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.
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 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 themselves without having immediate treatment.
If you have either of these results, your doctor will ask you to return for another smear test – a repeat smear – in six months’ time.
If the repeat smear is normal, you will be asked to have one more smear test in six to twelve months’ time to be sure that the cells are still healthy. If they are healthy, you will then go back to receiving routine investigations as before.
If your repeat smear still shows borderline changes or mild dyskaryosis, your doctor may suggest you have a further examination – called colposcopy. Colposcopy is used to decide whether you need treatment. This further examination– is carried out to investigate the cervix in detail.
For some women their result will show moderate or severe dyskaryosis.
It is unlikely that you have cancer. However, these changes are less likely to return to normal by themselves and usually need treatment.
It is important that these changes are checked now, in case they become more serious in the future.
If you need treatment following colposcopy you will usually be treated as an out-patient and there will be no need for you to stay in hospital. Treatment is nearly always 100 per cent successful.
After treatment you will need regular check-ups to make sure that the cervix is healthy again. You will need annual smears for the next four or five years.
Some women worry that having sex will make the problem worse and abnormal cells could be passed on to their partners. Sex does not make the abnormality worse and you cannot pass on abnormal cells.
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.
If you have treatment it will have little or no effect on your future fertility, nor on your risk of having a miscarriage.
Changes in the cells of the cervix are often associated with certain types of a virus which can be transmitted by sexual intercourse. The virus is called the Human Papilloma Virus (HPV).
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 known.
If you have any further questions regarding your condition or if you feel worried at all, do not hesitate to phone or make an appointment with either a GP or a gynaecologist at the Women’s Wellness Centre who will be happy to talk to you.