Cervical Smear Q&A

21 June 2017

What is a cervical smear?

A cervical smear is a sample of cells from the outside of the cervix (or neck of the womb) that allows detection of pre-cancerous abnormalities of the cervix.  These changes can then be treated successfully before cancer develops.

Smear tests are screening tools that might signal that more careful attention should be directed at the cervix. Sometimes smears can be reported as abnormal even though no abnormality exists on further examination. Very occasionally, smears may detect cancer cells in the presence of a cancer of the cervix.

Nowadays smears are called ‘cervical samples’ or 'liquid based cytology samples (LBC)' as they are no longer smeared on slides but collected in fluid filled bottles in a lab. This development is called liquid based cytology and the main advantage to this is it reduces the likelihood of any sample being unsatisfactory for examination.

My smear test is abnormal - what does this mean?

The vast majority of women with an abnormal smear do not have cancer, but precancerous changes in the cervix instead. This condition is called Cervical Intraepithelial Neoplasia (CIN). When these changes are found, it is normally very easy to get rid of them completely.

There are different grades of CIN according to how severe the changes are, from CIN1 (minor change) to CIN3 (the most severe change). The risk of developing cancer is related to the grade of CIN. We know that most cases of CIN1 will go back to normal without any treatment. However we know that CIN2 and CIN3 may develop into cancer in some cases, if left untreated.

There is also a rare abnormality called ‘Cervical Glandular Intraepithelial Neoplasia’ or CGIN. Treatment of CGIN is usually the same as CIN.

I have an abnormal smear. What is the chance that I have cancer? What is the purpose of Colposcopy?

Whilst about 1 in 20 women will have a smear test result which is abnormal, only about 1 in 2000 will have cervical cancer.  Many women worry about this possibility and this is where colposcopy is really helpful. The colposcopy will highlight any abnormal areas on the cervix and so it will be possible to achieve a confident diagnosis and successful treatment (if needed).

Treatment by colposcopy is simple and relatively easy and most importantly very effective at getting rid of the problem. Very rarely further treatment will be required.

Do abnormal smears run in the family?

No. There is no evidence that daughters and other female relatives of women with abnormal smears, pre-cancerous cells (CIN) or cervical cancer have an increased risk of abnormal smears, pre-cancerous cells or cervical cancer. Cervical smear abnormalities are common and it is not unusual for one or more family members to have had an abnormal smear, but there is no inherited predisposition to cervical abnormalities, CIN or cervical cancer.

Is having cervical screening like having a gynaecological MOT and w
hat are the cervical cancer signs and symptoms?

No. Cervical screening is designed solely to detect early cervical cell abnormalities which if left untreated, could lead to the development of cervical cancer at a time in the future. It is not designed to detect abnormalities in the ovaries, the womb, the vulva or the vagina.

Bleeding between periods, after sex or after menopause, vaginal discharge or pelvic pain could be signs of cervical cancer but in the majority of cases all these symptoms are due to benign causes and they are not related to any cancer process.

If you would like to make an appointment to see Mr Giannopoulos for a consultation or private smear test please call 01482 672 412.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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