Abnormal smear and colposcopy

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What Does an Abnormal Smear Mean?

Sometimes you will receive a borderline result, where there are some cell changes, but they are little different from normal. Alternatively, you may find that you have mild, moderate or severe changes in your cervical cells, but none of these mean that you actually have cancer of your cervix. An abnormal smear instead means that abnormal cells were found that have the potential to develop into cancer if you do not receive treatment.

What Is Recommended if a Smear Test Shows Mild Changes?

With mild or borderline changes, you may be advised to have a repeat smear test in six months time. Sometimes with mild changes, they can return to normal and if this is the case at your next test, you will usually have another two tests, six months apart, before resuming cervical screening at the usual intervals. However, if repeat screening is abnormal, you will receive a colposcopy. Though your doctor may recommend that even with a mildly abnormal smear result, you should initially have a colposcopy.

​A colposcopy provides a magnified image of your cervix, which can show changes that would otherwise be too small to see. The colposcope doesn’t go internally, but a speculum is used to allow access to view your cervix. If a biopsy of your cervix is necessary, you will have a local anaesthetic, so the procedure is painless.

What Is Recommended if an Abnormal Smear Shows Moderate or Severe Changes?

​You will need a colposcopy with a moderately or severely abnormal smear result and you will usually have a biopsy at the same time. Depending on the results of the biopsy you may need treatment, though if treatment is obviously necessary, you may receive it when you have the colposcopy.

What Treatments Are Available for an Abnormal Smear?

​A range of treatments are available to remove abnormal cervical cells. Some of these treatments (laser therapy, cryotherapy or cold coagulation) treat only the area of your cervix that has the abnormal cells, allowing healthy cells to re-grow.

Meanwhile, other treatments (cone biopsy, LLETZ or hysterectomy) remove all cells that could potentially become cancerous.

​In laser therapy, a beam of light with a high temperature removes the abnormal cells by burning them. However, you will receive a local anaesthetic in your cervix, so you won’t feel any pain. As soon as the procedure is over, you can return home.

​Contrary to its name, cold coagulation makes use of a hot probe to remove the cells responsible for the abnormal smear result. Although you shouldn’t be aware of the probe on your cervix, you may experience period-like pain during treatment and shortly after.

Cryotherapy freezes off the abnormal cells with the help of a cold probe. As with cold coagulation, you may experience some mild pain.

Diathermy uses an electric current to remove the tissue where the abnormal cells are. You will receive a local anaesthetic, but you should expect some bleeding and discharge for around four weeks following treatment. As this treatment doesn’t destroy the abnormal cells, it allows the tissue to be sent for the lab for further testing. Another treatment similar to diathermy is known as LLETZ (loop electrosurgical excision), which cuts the abnormal area using a wire loop and electric current. If you receive treatment at the same time as colposcopy, you will usually have LLETZ.

As the name suggests, cone biopsy takes away a cone-shaped segment of cervical tissue that contains all the cells that have cancerous potential. This procedure can either be done under local or general anaesthetic.

If you are post-menopausal or your family is complete, you may opt to have a hysterectomy, which removes your entire womb. This is usually recommended if you have abnormal cells a second time after treatment or you have a severely abnormal smear.