Diagnosing and grading CIN

If you have an abnormal test result after your screening test, your doctor may refer you for a colposcopy.

Colposcopy

What is a colposcopy?

A colposcopy shows the cervix in detail using a type of microscope called a colposcope. It acts like a magnifying glass, so that the person doing the examination can see the whole cervix clearly. A colposcopy is used to confirm whether you have CIN (or very rarely, if you have cancer) and how severe it might be.

Where will I have my colposcopy?

You will have your colposcopy at your local colposcopy unit, which is usually at a hospital outpatient’s clinic. Almost all hospitals with gynaecological units have the facilities for a colposcopy.

Who will do the colposcopy?

A specialist doctor or nurse colposcopist will do the colposcopy. Before your examination, you’ll have a chance to discuss your screening test results and any worries with the doctor or nurse at the clinic.

What does a colposcopy involve?

You’ll 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, so that your cervix can be seen. They will then paint the cervix with a liquid to make any abnormal areas show up more clearly. The doctor or nurse will shine a light onto the cervix and look through the colposcope at the surface of the cervix. The colposcope stays outside your body. They may take a small sample (biopsy) of cells from the cervix. These cells are examined under a microscope in the laboratory.

A colposcopy takes 15–20 minutes. It’s not usually painful, but you may feel some discomfort if a biopsy is taken. The biopsy may also cause some slight bleeding for a couple of days afterwards.


Colposcopists follow national guidelines when deciding whether you need further tests or treatment.

Grading of CIN

CIN is graded depending on how deep the cell changes go into the surface of the cervix:

  • CIN 1 – one-third of the thickness of the surface layer is affected.
  • CIN 2 – two-thirds of the thickness of the surface layer is affected.
  • CIN 3 – the full thickness of the surface layer is affected.

Knowing the grade of your CIN helps your colposcopist plan the best treatment for you.

With all three grades of CIN, often only a small part of the cervix is affected by abnormal changes.

CIN 3 is also known as carcinoma-in-situ. Although this may sound like cancer, CIN 3 is not cervical cancer. Cancer develops when the deeper layers of the cervix are affected by abnormal cells. If CIN 3 is found during screening tests, it’s important to make a treatment plan.

‘It was not an unpleasant experience. The doctor was superb. They took me through what was going to happen and asked me if I had any worries about the procedure.’ Anna

Anna

Your feelings about abnormal screening results

People react differently to their screening results. There is no right or wrong way to feel.

Fear

If you are told you have an abnormal screening test result, your first reaction may be fear. You may immediately think that you have cancer. It’s important to remember that most women who have an abnormal result have early changes in the cells and do not have cancer.

Shame

There has been a lot of publicity about CIN and its link with sexual activity and HPV. This has sometimes led to women feeling guilty or ashamed if they have CIN. However, you should not feel you are to blame in any way.

Most women have HPV at some point in their life without even knowing it. In most cases, the immune system will get rid of the virus naturally.

Embarrassment

You may find the treatments for CIN embarrassing and possibly frightening. Don’t be afraid to ask your doctor or nurse as many questions as you like, as this may help to put your mind at rest.


If you feel that you need support, you can contact our cancer support specialists on 0808 808 00 00.

CIN3 and CGIN experiences

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos

CIN3 and CGIN experiences

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos

Back to Cervical screening and CIN

The cervix

The cervix is the lower part of the womb (uterus). It’s often called the neck of the womb.

Abnormal test results

If you have an abnormal result, this does not mean you have cancer. You may need some more tests.

Treating CIN

If you have been diagnosed with CIN, you may have treatment to remove the abnormal cells. There are different types of treatment.

After treatment for CIN

Most women feel fine after treatment for CIN but some may feel unwell for a few hours. You will be referred for regular screening tests.