Cervical Screening

Does an abnormal result mean I have Cancer?

An abnormal result is not unusual: About 1 in 20 women have test results that show some abnormality. Cervical screening is designed to pick up minor changes before any problem develops. It is important to remember that it is extremely rare for an abnormality found at the 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.

Small changes found in the cells on the cervix (the neck of the womb) are called dyskaryosis. In many cases, the cells return to normal by themselves. But sometimes the abnormalities may become worse and could lead to cancer. In such cases, further examinations like Colposcopy help in determining if any treatment is needed. The treatment itself is simple and usually 100% effective.

Fortunately, cervical cancer usually takes many years to develop. So it is very rare, especially in women who have regular cervical screening, for an abnormal result to be indicative of cancer.

What causes the abnormality?

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.

What happens now?

It is safe to give small changes a chance to return to normal without any immediate treatment. In such cases, your doctor will usually ask you to return for a repeat screening test in six months. If the screening shows the cells have returned to normalcy, you will be advised to do two more tests at an interval of six months to be sure that the cells are still healthy. If your repeat test still shows borderline changes, you may need further examination (Colposcopy). Even if the result shows moderate or severe dyskaryosis, it is unlikely that you have cancer. However, these changes are less likely to return to normal without treatment.

What is Colposcopy?

Colposcopy is a simple examination that investigates the cervix more minutely and helps determine the need for and course of treatment. An instrument called a Colposcope is used during the process. This is a type of microscope or magnifying glass that lets the doctor look more closely at the changes on your cervix. It does not touch you or go inside you.

What about treatment?

The treatment, if required, does not need a hospital stay. The area of changed cells is removed from the cervix under local anaesthesia. It is nearly always completely successful. After completion of treatment, two follow-up screening tests at an interval of six-months are advised, followed by a test every year for up to nine years, if no other abnormality is detected.

What about sexual intercourse?

Sex does not aggravate the condition and there is no risk of you passing it on to your partner. The use of an effective contraceptive is, however, recommended. It is important to not conceive 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.