The most common treatment for high-grade cervical cell changes is conization, the removal of a cone-shaped piece of tissue from the cervix and cervical canal.
About 5% of all Pap tests will be abnormal, meaning that the sample contains atypical cervical cells. However, the majority of these cells are not cancerous or even precancerous. An abnormal Pap test result does not mean cancer, but it does require follow-up to rule out the possibility of cancer.
If treatment is needed, the aim is to remove the abnormal cervical cells while preserving as much normal tissue as possible. The most common treatment is large loop excision of the transformation zone (LLETZ). The transformation zone is the area of tissue just at the entrance of the birth canal.
Colposcopy. If you have certain symptoms that could mean cancer, if your Pap test shows abnormal cells, or if your HPV test is positive, you will most likely need to have a test called colposcopy. You will lie on the exam table as you do with a pelvic exam.
If the answer is “more than three years,” it's time to call our office and schedule an exam. At Physicians for Women, we use the ThinPrep Pap Test, which is the most effective and widely used test available and has been proven to increase early detection of precancerous cells.
In most cases, an abnormal Pap test is a result of: A human papillomavirus (HPV) infection. A sexually transmitted infection (STI or STD), such as herpes or trichomoniasis. A bacterial or yeast infection.
“I Received an Abnormal Pap Test. What's Next?” Your next step is usually a minor procedure called a colposcopy. This procedure is a visual examination of the cervix using a low-powered microscope used to find and then biopsy abnormal areas in your cervix that may lead to cervical cancer.
LSIL ~ Low-grade squamous intraepithelial lesion
These lesions, in women with intact immune systems, often resolve without intervention within 18 to 24 months. Low-grade lesions may also be called mild dysplasia, or CIN1. If it is your first abnormal Pap smear, your doctor will likely recommend a colposcopy.
Cervical cell classes: (A) normal squamous, (B) normal columnar, and (C) low-grade dysplasia; (D) high-grade dysplasia (HGD) with moderate dysplasia, (E) HGD with severe dysplasia, and (F) carcinoma in situ.
A cervical biopsy may be done when abnormalities are found during a pelvic exam. It may also be done if abnormal cells are found during a Pap test. A positive test for human papillomavirus (HPV) may also call for cervical biopsy. HPV is a type of sexually transmitted infection.
If you have abnormal cells from your screening test you have a test called a colposcopy to have a closer look at your cervix. The doctor or nurse can take samples of your cervix during this test. You need to have treatment if this comes back showing changes.
A colposcopy is relatively painless. You may feel slight pressure when the speculum enters your vagina. You may feel a slight burning or stinging when the solution comes into contact with your cervix. If you need a biopsy, you may feel a sharp pinch or a sensation like a period cramp when the tissue sample is excised.
Precancerous conditions of the cervix are changes to cervical cells that make them more likely to develop into cancer. These conditions are not yet cancer. But if they aren't treated, there is a chance that these abnormal changes may become cervical cancer.
The STIs that can be diagnosed by Pap smear are trichomoniasis, HPV infection, herpes genitalis, candidiasis, and bacterial vaginosis.
Although it's common to feel uneasy, you should know that most women who have abnormal cervical screening test results do not have cervical cancer. Most have early cell changes that can be monitored (since they often go away on their own) or treated early (to prevent problems later).
Higher risk: Your test results show either HPV infection with types 16 and/or 18, high grade cell changes on your cervix, or persistent infection with one of the other high-risk HPV types (not 16/18). It is important that you have a further follow-up because you may be at a high risk of developing cervical cancer.
There are actually lots of reasons your Pap smear may come back “abnormal.” You may have an infection or inflammation, growth or cysts, changes in your hormones (usually due to pregnancy or menopause), problems with your immune system related to diabetes, HIV, or autoimmune diseases.
Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.
Repeat testing—For patients under 25, a repeat Pap test may be done in 6 months or 1 year. For patients 25 or older, repeat HPV testing or co-testing (having the HPV test and Pap test done at the same time) is recommended as a follow-up to some abnormal test results.
Conization. Doctors remove a cone-shaped piece of tissue from the cervix in a procedure called conization. They may use conization to remove precancerous tissue high up in the cervical canal, along with a border of surrounding healthy tissue, to help ensure that all of the precancerous cells have been taken out.
The abnormal tissue is removed using a thin wire loop that is heated electrically. The aim is to remove all the abnormal cells from the surface of the cervix. A LLETZ or LEEP is done under local anaesthetic in your doctor's office or under local or general anaesthetic in hospital. It takes about 10–20 minutes.
During a cone biopsy, your healthcare provider will remove a small, cone-shaped part of your cervix. They will study it under a microscope to look for abnormal cells. It usually takes about 4 to 6 weeks for your cervix to heal after this procedure.
It may take 4 to 8 weeks to get colposcopy results. Your colposcopist usually sends a letter with your results. If your results take longer than this, you can call the hospital or your colposcopist to check on them.
It takes four to six weeks for your cervix to heal. To reduce the risk of infection during this time, you should avoid sexual contact or wearing tampons. It is advisable to wear sanitary towels during this time. Have a shower rather than take a bath for six weeks following a treatment at colposcopy.
Following the procedure, a person should feel fine as soon as it is over. Light spotting or cramping may occur, but people can continue with their daily activities and do not need to avoid vaginal sex. However, if the doctor performed a biopsy, it can take 1–2 days to recover.