Management of Abnormal Cervical Smears

What is the management of abnormal cervical screening results?

HPV infection is usually cleared by the body’s own immune system within months to a few years. 

Abnormal cervical smears are called ‘Cervical Intraepithelial Neoplasia’ (CIN). CIN is categorised as low grade (known as CIN1), or high grade (CIN2 to 3). The majority of low grade changes i.e. CIN1, are harmless and return to normal by themselves. People with high grade changes, i.e. CIN2 or 3, are treated to avoid the risk of progressing to cancer. High grade changes are not cancers and they take many many years to turn into cancer.

Depending on the degree of smear abnormality and sometimes HPV DNA result, the doctor or nurse may recommend a colposcopy examination. HPV DNA tests are used in certain clinical situations usually in conjunction with a smear test. The test can be helpful in deciding what follow-up is required. More information on HPV testing is available on www.timetoscreen.nz/cervical-screening/.

A colposcope is like a pair of medical binoculars on a stand and it magnifies the cells on the cervix. Colposcopy shows where the abnormal cells are. A tiny piece of tissue may be removed (a biopsy) which may cause brief discomfort. The biopsy is sent to a laboratory to confirm if an abnormality is present. These procedures are simple and require only a short visit to a hospital clinic or private specialist.  

Depending on the results of this test, you may be advised to have a repeat cervical smear, a further colposcopy, or it may be recommended that the abnormal cells are removed by a simple outpatient treatment. 

In some situations, the specialist may request HPV Type testing to assist in further management.

Treatment is only required if there are certain abnormal cell changes of the cervix.

What about the future?

Most cervical cancers can be prevented by HPV vaccination, having regular cervical screening and following National Cervical Screening Programme (NCSP) recommended guidelines if any abnormalities are identified. There is no evidence that HPV affects the ability to have children.

Smoking decreases the immune system’s ability to deal with the HPV virus and therefore may increase the risk of developing abnormal cell changes. 

More information on cervical screening is available on www.timetoscreen.nz/cervical-screening/.