Ask the Expert: Abnormal Cervical Smear Test Result

Ask the Expert: Abnormal Cervical Smear Test Result

It’s the Cervical Cancer Prevention Week this week and Spire London East is joining the conversation to bring more awareness about the next steps after an abnormal cervical smear result. Our questions are answered by Miss Farida Bano, Consultant Obstetrician and Gynaecologist at Spire London East Hospital.

A few facts and figures¹

• Cervical cancer is a cancer arising from the cervix. The cervix is the lower part of the uterus in the human female reproductive system.
• There are around 3,200 new cases of cervical cancer in the UK every year, that’s around 9 cases diagnosed every day (2013-2015). Cervical cancer is the 14th most common female cancer, with around 3,100 new cases in 2015.
• In females in the UK, cervical cancer is the 19th most common cause of cancer death, with around 850 deaths in 2016. More than half (52%) of cervical cancer cases in the UK each year are diagnosed in females aged under 45 (2012-2014).
• 3126 new cases of cervical cancer, 2015, UK
• 854 deaths from cervical cancer, 2016, UK
• 63% of women survive cervical cancer for 10 or more years, 2010-11, England & Wales

Regular cervical screening is important to detect abnormalities which can be treated early to prevent cancer developing. Not going for cervical screening is one of the biggest risk factors for developing cervical cancer. Abnormal results may suggest the presence of precancerous changes, allowing examination and possible preventive treatment.

You have had an abnormal result from your cervical smear. What’s next?
Cervical smear is designed to pick up minor changes before any problems develop. Most women's test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix². Most of these changes won't lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be removed so they can't become cancerous.

What are the symptoms of cervical cancer?
The most common symptom of cervical cancer is abnormal vaginal bleeding, usually between periods, after sex or after the menopause (who are no longer having the period). Symptoms of cervical cancer can also include a smelly vaginal discharge and discomfort during sex. Very early stage of cervical cancer may have no symptoms. This means it’s important to have regular cervical screening so that any cells can be picked up early. Usually these symptoms won’t mean you have cancer, and there are many conditions that can cause these symptoms but it’s important to let the doctor know.

What is HPV?
Human papilloma virus (HPV) is the name for a group of viruses that affect the skin and the moist membranes lining the body. e.g. cervix, vagina, vulva, anus, mouth and throat. The types of HPV that can cause abnormalities of cervix are most commonly passed through sexual contact.

Four out of five (80%) people will be infected with genital HPV at some time during their lives¹. High risk HPV infection can cause changes to the cells of the cervix causing abnormalities. Once these abnormalities become severe they can develop into cancer.

High risk HPV does not have any symptoms; most people do not even know they have it. There is no treatment for high risk HPV as the body’s immune system will usually clear the infection.

What is colposcopy?
This is a simple outpatient clinic procedure to examine the cervix. As an experience it is very similar to having a smear test performed. Colposcopy is a more detailed look at the cervix using a microscope. It does not touch you or go inside you.

Sometimes a biopsy is required. This means taking a tiny piece of skin from the cervix with a special instrument.

What about treatment?
If you need treatment following colposcopy you will usually be treated as an outpatient and there will be no need for you to stay in hospital. Loop cone biopsy or large loop excision of transformation zone (LLETZ) is a simple procedure that aims to remove abnormal cells from your cervix. In most cases we are removing cells that may be precancerous and removing them now can prevent them progressing to cancer in the future. Most Loop cone biopsies are done under local anaesthetic in the Colposcopy clinic. This means you are awake but the area to be treated is made numb by anaesthetic. When we are sure the cervix is anaesthetised, the abnormal area is removed using an electrically heated loop shaped wire. The piece of tissue that is removed is sent to the laboratory for further testing.

These treatments are simple, relatively easy and effective at getting rid of the problem and returning you to normal tests. 

What follow up will I need?
If you do need treatment, you will be asked to have a follow-up smear test six months afterwards to check that all the abnormal cells have gone.

Should I worry about cancer?
Cervical cancer is rare in women who get regular screening tests. It’s very important that if you have been referred to colposcopy you should keep your appointment.

Book an appointment
Miss Bano holds clinics at Spire London East Hospital on Tuesday morning, Wednesday afternoon, Friday morning and Saturday afternoon.

To book an appointment call our Private Patient Executives on 020 8709 7817 or enquire here.

Reference:

• cancerresearchuk.org
• https://www.nhs.uk/conditions/cervical-screening/
• Colposcopy and Programme management BNHSCSP Publication 20