Abnormal Smear Test
Depending on the degree of abnormality, it may be necessary to have a repeat cervical screening test or be referred to a Consultant Gynaecologist for a colposcopy. The urgency of referral depends on the result of the cervical screening test:
- Borderline change is the mildest abnormality result of cervical screening, with about 3-4% categorised as borderline. The cells are not abnormal enough to be categorised as dyskaryosis.
- Mild dyskaryosis is a common abnormal result from cervical screening and about 2% of tests show mild abnormalities of cervical cells. In most cases, the abnormalities go back to normal without any treatment.
- About 0.6% of smear tests show either moderate or severe dyskaryosis. However even with this result, it is still very unlikely that you will have cervical cancer. With moderate or severe dyskaryosis, the abnormalities are less likely to return to normal without treatment, so you will be referred to a Consultant Gynaecologist for colposcopy.
- Less than 0.1% will have more serious abnormalities such as invasive or glandular neoplasia. Invasive neoplasia suggests cervical cancer might be present, but it is not proven until a biopsy has been taken during a colposcopy.
- Glandular neoplasia suggests that there is an abnormality in the lining of the womb rather than on the cervix. Glandular neoplasia does not necessarily mean cancer, but you will need to be referred for colposcopy.
An abnormal smear test is often caused by the Human Papilloma Virus (HPV or Wart virus). This is a very common infection and 60-70% women get it at some stage in life. Most women will shake it off through their immunity, but in some women it may linger on and cause an abnormal smear test.
Remember that it is rare for cervical cancer to be found on cervical screening. Cervical screening is designed to find early changes that could become cancer if left untreated.
A colposcopy is a procedure where the lining of the cervix is closely examined using a magnifying instrument called a colposcope to check the cells for abnormalities.
Modern colposcopy clinics are fitted with video equipment that allows the Consultant Gynaecologist to view the examination on a monitor. The patient is able to watch the procedure if they wish, to help reduce any nervousness and anxiety.
After closer examination of the cervical cells, your Consultant will be able to determine the extent of any cell abnormalities and any treatment that is required. If the colposcopy confirms that there are cervical cell abnormalities, a biopsy may be carried out, removing a small sample of tissue for closer examination and testing. The treatment of abnormal cervical cells is almost always 100% successful. Following treatment, it is unlikely that any cell changes will occur in the future.