The test checks the cells from your cervix. In most women the cells are normal. Abnormal cells are found in some women. An abnormal result does not mean cancer in the vast majority of cases. Abnormal cells indicate that cancer may develop sometime in the future. Treatment can be given to prevent cancer from developing in women with abnormal cells. So, the test aims to prevent cancer, and not to detect cancer.
All women aged 25 to 64 should have regular tests. For women aged 25-49 it is usually done every three years. For women aged 50-64 it is usually done every five years. From the age of 65, most women do not need any more tests. However, women aged 65 or over who have not had a test since age 50, or have had recent abnormal tests, will still be advised to be screened. So, a test may be advised for some women aged 65 or more
Cervical cancer (cancer of the cervix) is not uncommon. In recent years the number of cases has fallen due to cervical screening tests. However, there are still over 2000 new cases of cervical cancer diagnosed each year in the UK. Cervical cancer can be prevented if you have regular screening tests.
Most women have the test at the D2 medical, their local GP or at the rotunda hospital
Normal result
About 9 in 10 routine cervical screening tests are normal. You will be sent a letter inviting you for another one in 3-5 years. (Note: a normal result means you have a very low chance of developing cancer of the cervix – not a 100% guarantee that it will not occur.)
Inadequate test
This sometimes occurs. This simply means no result can be given. For example, if the smear method was used, an inadequate test may occur because there was some blood or too much mucus on the slide and the cells could not be seen properly. Sometimes it is because a smear of cells was too thick or too thin to assess properly. You will be asked to attend for a repeat test. However, with the newer liquid based cytology method, the number of tests that are ‘inadequate’ and need repeating is much less than with the traditional smear method.
Abnormal result
Some changes in the cells are found in about 1 in 10 tests. There is a range of changes that may occur. In nearly all cases, these changes do not mean cancer.
Minor or borderline abnormal changes are quite common. These often clear away on their own and most mild changes do not progress to anything serious. However, any change needs to be monitored as some may progress to become more serious in the future. A repeat test after 3-12 months is commonly advised, depending on the type and degree of change. Often the changes will have gone when the test is repeated. If the changes do not go, or the changes are more marked, then a referral to colposcopy is advised. Rarely, a cancer of the cervix is diagnosed by a cervical screening test.
Colposcopy is a more detailed examination of the cervix. In this test a speculum is gently put into the vagina so the cervix can be seen. The doctor uses a magnifier (colposcope) to look at the cervix in more detail. A liquid is used to ‘paint’ the cervix which shows up the abnormal cells. It takes longer than a normal screening test (about 15 minutes). It is done by a specialist at hospital. During colposcopy it is usual to take a small piece of tissue from the cervix (biopsy) to make a more detailed assessment of the cells.
Yes. A minor abnormal change often goes away by itself. This is why a repeat test after 3-12 months may be all that is needed. If the cells remain abnormal, or the changes are more marked, then treatment is offered. This will stop cancer from developing in the future.
The types of treatments that are used include:
Cryotherapy – freezing the affected area of the cervix which destroys the abnormal cells.
Laser treatment – this destroys or cuts away abnormal cells.
Loop Diathermy – a thin wire loop cuts through and removes the abnormal area of cells.
These treatments are done as an out-patient and do not take long. They are usually successful and are usually needed only once. Follow up and regular screening tests are needed for the next few years check that the treatment has been successful. It takes a few weeks for the cervix to heal after treatment. Once it has healed, a normal sex life can be resumed. Treatments do not affect fertility.