You may be referred into our care following a routine cervical smear where an abnormal result has been found. Alternatively your GP may refer you to the colposcopy clinic if they suspect that there may be other abnormalities on your cervix; either because of symptoms that you have, or because of what they have found on examination.
Abnormal smears are caused by the human papilloma virus (HPV) there are many sub types of this virus. The main cancer causing sub types are 16 and 18 but there are at least 12 sub types which are carcinogens (cancer causing). If you have an abnormal screening test which shows the presence of one of the sub-types of virus then you will be referred to colposcopy for an examination.
Approximately 80% of the sexually active population will acquire the HPV virus at some time. Most people are never aware they have been in contact with the virus as it usually clears on its own. However sometimes it persists and can lead to precancerous changes on the cervix. For more information visit Jo’s Cervical Cancer Trust.
The National Cervical Screening Programme has now changed and all women who are eligible for cervical screening will be HPV tested when they attend for their smear. If there is evidence of the virus in your test then the laboratory will look for abnormal cells, if you are HPV negative then you will continue on the routine cervical screening programme.
You will come to colposcopy with the following results:
- HPV positive – borderline squamous/endocervical
- HPV positive – low grade dyskaryosis
- HPV positive – high grade moderate or severe
- HPV positive – possible glandular neoplasia of endocervical origin
- HPV positive – possible invasive cancer
At Colposcopy we are able to diagnose and treat precancerous changes of the cervix that might develop as a result of an HPV infection. Colposcopy forms an integral part of the NHS cervical screening programme and aims to reduce the number of women who develop cervical cancer and the amount of women who die from it.
The benefit of having regular smears, as recommended by the national programme, is that it allows us to identify precancerous changes early where we may either offer surveillance until the smear returns to normal or treat the cervix with a LLETZ (large loop excision of the transformation zone) where high grade precancerous changes are removed to reduce the risk of you developing cervical cancer in the future. In over 85% of cases, a single such treatment will successfully remove the precancerous cells and the smear test will go back to normal
We also investigate other symptoms which may have a cervical cause.
These symptoms include:
- Bleeding with intercourse
- Bleeding in between your periods
- Persistent abnormal discharge that has not responded to usual treatments and where swab test have not revealed any infection.
- Possible abnormal appearances of the cervix.
We also run specialist vulval (the skin and lips surrounding the vagina) clinic where we investigate and treat:
- Precancerous abnormalities of the vulva (VIN – vulval intraepithelial neoplasia).
- We also see patients with vulval symptoms or lesions (such as cysts or ulcers) when the GP is concerned about the possibility of cancer.