Gynaecology

Abnormal Cervical Screening Test

An Abnormal Cervical Screening Test requires respect and attention. A cervical screening test is a screening test for cervical cancer (previously known as a Pap smear). Detecting and treating early cellular changes effectively prevents cervical cancer, and can save a woman from requiring a hysterectomy.

Dr Raelia Lew is expertly qualified in colposcopy (microscopic assessment of the cervix), monitoring and treatment of cervical abnormalities.

Colposcopy: Pretreatment Information

What is colposcopy?

 Colposcopy is a technique of detailed examination of the cervix (entrance of the womb) using a variety of stains to identify abnormalities. A small biopsy of any suspected abnormal areas identified may be taken using a specially designed biopsy forceps. Cervical biopsy specimens are smaller in size than a quarter of a grain of rice, but they provide important cellular information that can be interpreted by a pathologist to assess your risk of developing a cervical cancer.

Why have I been referred for colposcopy?

You have been referred for colposcopy because a possible abnormality of the cervix has been suspected. This may be because:

A) You have been found to be infected by a high risk strain of the Human Papilloma Virus (HPV) on DNA analysis
B) You have had abnormal cells suspected on a routine cervical screening test
C) You have experienced abnormal vaginal bleeding, between menstrual periods of after sexual intercourse.

Colposcopy is a way of better assessing your risk of developing cervical cancer. Pre-cancer changes can be detected at colposcopy. If confirmed, treatments can subsequently be arranged to prevent cancer development.

What is HPV? Is it sexually transmitted?

HPV is a family of viruses. Hundreds of strains of HPV exist.  About 30 strains of HPV have been associated with an increased lifetime risk of a woman developing cancer of the cervix. Once contracted, HPV can persist for many years. In December 2017, Australia changed the way we screen women for cervical cancer, for the first time assessing HPV DNA status together with cellular changes. Previously, cervical cell changes alone were assessed (known as a pap smear). Discovering the presence of an HPV infection on routine screening does not indicate a partner’s recent infidelity.

Having HPV does not mean a woman will definitely develop cervical cancer; it is simply a recognized risk factor.

What is involved in colposcopy?

A colposcopy procedure takes 15 to 20 minutes to perform. An instrument called a speculum is inserted into the vagina so that the cervix may be visualized.

The area of interest is called the cervical transformation zone. This is the area where the glandular cells lining the inner cervix transform into the outer squamous cell type of the external cervix. It is in this region that HPV high-risk strains may cause a persistent infection. Chronic inflammation caused by HPV is a risk factor for a woman developing cervical cancer over many years.

Stains commonly applied at colposcopy include acetic acid (a gentle vinegar stain) and aqueous iodine. These strains help highlight abnormal areas so that a target biopsy can be performed to accurately characterize cervical changes.

If a cervical biopsy is performed, bleeding may occur as the cervix has an extremely rich blood supply. Silver nitrate paste may be applied to the biopsy site to cauterize procedural bleeding. Healing extremely is rapid. Intercourse and tampon use should be avoided for 24 hours after a cervical biopsy procedure. No other subsequent precautions are necessary.

Will I require a follow up appointment?

It is important that you arrange and attend a follow-up appointment to discuss cervical biopsy results and to confirm an action plan for your ongoing cervical monitoring. Annual review may be recommended if lower risk concerns are present. If pre-cancer changes are confirmed, treatment to remove the abnormal cells may be recommended on the basis of your cervical biopsy assessment.