Colposcopy - What To Expect

This month is Cervical Cancer Awareness month in the UK, and we wanted to break the stigma surrounding not just the disease itself, but the processes that are in place for preventing it.

We have already talked about what you can do personally to help prevent it, and Wednesday's article went more deeply into smear tests and how the process works. We all know its not a dignified process, and for most women if you could avoid it you would, but the reality is, that few minutes of discomfort could be lifesaving.

The question is though - what happens when the results come back and there are some possible concerns?

Here at Normedica headquarters, we have all experienced this at one time or another which shows just how common it is.

The process starts with a test coming back that shows the presence of HPV in the cervix or pre-cancerous cells, or possibly both.

From us to you - if you are being checked regularly - this shouldn't be a concern. Cervical Cancer is extremely slow growing and caught early, very treatable.

Initially, based on the results, the nurse will recommend that you come back for a second test in 12 months time. A lot of the time, everything goes back to normal within that 12 months, but if it doesn't, a letter will usually be sent to your home address to invite you in for a colposcopy - a closer look at the cervix to examine the cells.

The use of the word pre-cancerous on the letter you receive is unfortunate, and can put the fear of God into you if you haven't experienced it before. What that actually means is that those cells have grown abnormally which leaves them looking slightly different.

These changes may increase the risk of cancer, but there is no guarantee that they will ever develop into cancer. In the majority of cases, they will stay as they are or morph back into normal cells.

If you are invited in for this procedure, what can you expect?

We know - it looks very undignified but this allows the Doctor to determine whether the abnormalities on your cervix are something that needs to be investigated further. The process itself takes between 10 and 20 minutes and will usually proceed as follows:

• Once you have arrived, the Doctor will ask you to undress from the waist down and lie on a bed with your knees bent. Unlike with a smear, this time your feet will most likely be placed in stirrups or padded supports so you are comfortable whilst the procedure is taking place.
• A lubricated speculum is placed inside the vagina and it is opened gently.
• The Doctor will then use the colposcope to take a closer look at the cervix. The instrument itself doesn't enter the body at any point or even come into contact with your skin. It will sit around 30cm away from your body. There is a good chance that the cells will be shown on a screen, allowing the Doctor to see your cervix much more clearly.
• There are different coloured liquids dabbed onto the cervix which change the colour of any abnormalities and allow the Doctor to see them more easily. If there is anything they feel needs to be looked at further, they may take a biopsy of the cells which will be sent off to the labs for checking.

And that's it!

Sometimes, they are able to give you an overview in the room, but any results will usually take up to 4 weeks to come through from the labs.

Although this will be the end of the process for 4 out of 10 women, around 6 out of every 10 will have abnormal cells at colposcopy. The medical term for those cells is CIN (cervical intraepithelial neoplasia), and ladies, this still doesn't mean cancer.

All it means is that there is a possibility that these cells could go onto become cancerous.

Because of this, the condition is graded low or high to determine whether the cells can be left, or whether they need to be removed.

Low grade (CIN1) means there are no immediate concerns. This tends to be what happens with most cases meaning you don't need to return for 12 months. At that point, another smear will be done to check the condition of the cells and the process begins again from there dependant on the results.

High Grade (CIN2 & 3) means you are more at risk of developing cancer than someone with low grade changes. Treatment is offered at this stage to remove the cells and you will be monitored with regular smear tests until the Doctors are satisfied that there are no more concerns.

Treatment for cell removal is much less of a big deal than you might imagine. Its a day appointment, and you will be awake whilst its being done. The cells are removed under local anaesthetic and although it will leave you uncomfortable for a few days, its nothing a bit of TLC and some paracetamol won't fix!

Cervical Cancer. We cannot stress enough how rare this is.

If this does happen, you are immediately referred to specialists who will take over the treatment at that point. Cancer diagnosed through screening does tend to be found at an earlier stage which is why screening is so important. The survival rate is much higher, especially for cervical cancer when it is found early.

Cancer is a worry no matter who we are, and when symptoms appear, giving yourself the best chance of survival means swallowing that fear and getting checked out.

The beauty of the smear is that prevention is already in place. You just have to be willing to bite the bullet and give your body the chance it needs and deserves.

For more information on screening, check out the links below.

Cervical screening: helping you decide - GOV.UK

Cervical screening - NHS