Tests after an abnormal cervical screening result

Most abnormal results from screening tests show only very minor changes. These are called borderline or mild changes or mild dyskaryosis. Many of these will go back to normal on their own, so your GP may simply arrange for you to have further screening tests 6, 12 and 24 months later. If you smoke, it may help if you try to give up as this will make it more likely that your cervical cells go back to normal.

If your second screening test still shows abnormal cells, your GP or practice nurse may then arrange for you to have some further tests.

On the other hand, some doctors will refer you for further investigation after just one abnormal test result, however minor.

A smaller number of women will have moderate or severe changes (CIN 2 or CIN 3). These are known as moderate or severe dyskaryosis. If this is the case, your GP or practice nurse will suggest that you have a further test, known as colposcopy, within a few weeks.

If you need to have colposcopy you will be referred to your local colposcopy unit, which is usually at a hospital outpatients clinic. You do not normally have to stay overnight. Almost all hospitals with gynaecological units have the facilities to do colposcopy.

Colposcopy shows the cervix in detail using a colposcope. A colposcope is a specially adapted type of microscope. It acts like a magnifying glass so that the colposcopist can see the whole cervix in more detail.

Colposcopy can be carried out by a specialist doctor or a nurse colposcopist. Doctors and colposcopy nurses follow national guidelines when deciding whether you need further tests or treatment. Before your test you will have a chance to discuss your screening test results, and any worries that you may have, with the doctors or nurses at the clinic.

You will be helped to position yourself on a specially-designed chair or examination table. When you are lying comfortably, the colposcopist will use a speculum – in the same way as in the screening test – to hold your vagina open. The cervix is then painted with a liquid to make the abnormal areas show up more clearly. A light is shone onto the cervix and the doctor will look through the colposcope (which stays outside your body) to examine the surface of the cervix. A small sample (approximately the size of a grain of rice) of cells from the cervix (a biopsy) may be taken to be looked at under a microscope.

Colposcopy takes a bit longer than the screening test, about 15–20 minutes. It is not usually painful, but you may feel some pain if a biopsy is taken. You may also have some slight bleeding for a couple of days afterwards.

If the abnormal area still cannot be seen clearly with a colposcope, the colposcopist may arrange for you to have a cone biopsy or LLETZ (large loop excision of the transformation zone).