Abnormal smears and colposcopy

Being told your smear test is abnormal is frightening. It is worth saying clearly at the outset: an abnormal smear result very rarely means cancer. Most changes picked up by screening are minor, and many resolve without any treatment at all.

What an abnormal result means

Cervical screening looks for the human papillomavirus (HPV) and for changes in the cells of the cervix. HPV is extremely common and most people encounter it at some point; in the great majority it clears by itself.

When cell changes are found, they are graded by how marked they are. These are pre-cancerous changes, not cancer — and the whole purpose of screening is to identify them at a stage where they are simple to treat.

What happens at colposcopy

Colposcopy is a closer look at the cervix using a magnifying instrument that stays outside the body. It is similar to having a smear test and usually takes around fifteen minutes.

A liquid is applied to the cervix to make any abnormal areas visible. If an area looks abnormal, a small biopsy may be taken. Some women find this uncomfortable for a moment, but it is generally well tolerated and does not require an anaesthetic.

If treatment is needed

Where significant cell changes are confirmed, the affected area can be removed in a short procedure, usually under local anaesthetic, in the outpatient setting. This is highly effective.

Afterwards you can expect some bleeding and discharge for a few weeks, and you will be advised on when it is safe to resume normal activities. A follow-up smear is arranged to confirm that everything has settled.

Looking after yourself while you wait

The period between an abnormal result and a colposcopy appointment is often the hardest part. If it helps, remember that the screening programme is designed with a wide safety margin — it deliberately picks up minor changes so that nothing significant is missed.

If you have questions in the meantime, please ask. Understanding what is happening usually helps more than waiting quietly with the worry.