Abnormal Smears and Treatment / Cervical Cancer Screening

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When a woman receives an abnormal smear result, this can be a very concerning time. Our consultants at Windsor Medical Group can offer an urgent private appointment to discuss the smear abnormality and further management. An urgent appointment can be organised if necessary for a private colposcopy which is a more detailed microscopic examination of the cervix (neck of the womb). Please refer to our section on abnormal smears / colposcopy and cervical cancer screening.

For further information contact us through our website.

If a woman has an abnormal smear, she may be referred to a consultant at Windsor Medical Group for further investigation. This is done using a colposcope (high powered microscope). Colposcopy is a subjective assessment by a trained and certified individual. A colposcope is used to visualise the cervix under magnification and allows the gynaecologist (colposcopist) to take biopsies or treat the area of abnormality if detected.

There are 3,000 cases and 1,000 deaths from cervical cancer each year in the UK. The peak age at diagnosis is 35-39 years. Every year 80-90 women in Northern Ireland are diagnosed with cervical cancer. Fortunately the majority of cervical cancers are diagnosed at an early stage. In the developing/third world 80% of cervical cancers are advanced (FIGO stage III/IV – disease spread beyond the cervix). The reason for this difference – CERVICAL SCREENING.

The majority of abnormal smears are caused by a virus, known as HPV. This virus infects 80% of the population by the age of 50 years. It is possible to test for this virus, but this should be done in context with your smear and results interpreted by a Gynaecologist trained to manage abnormal smears / HPV.

Cervical screening was introduced across the UK in 1985. Current guidelines recommend cervical cancer screening from 25-64 years of age. Smears should be taken every 3 years until the age of 50 years. After 50 years of age, smears should be taken every 5 years until exit from the screening programme at 64 years. (these quoted figures are for women with normal smears. The frequency of smears will change if there have been abnormal smears detected).

Treatment of an abnormality may be conservative (i.e.: observational) or active (destruction or removal of the abnormality). Many abnormalities will resolve spontaneously. Observational management involves close follow with repeat smears and colposcopy. The higher the grade of the abnormality the less likely it will resolve spontaneously. Therefore active treatment may be used. This can involve destruction of the abnormal cells with “Cold Coagulation “. The term cold can be misleading, because the procedure involves touching the cervix with a hot probe to destroy the abnormal cells. This procedure is normally done in outpatient clinic, under local anaesthetic.

An alternative to cold coagulation is LLETZ (Large Loop Excision of Transformation Zone). This procedure removes the abnormality and is also performed under local anaesthetic in the outpatient clinic.
Follow up after treatment is individualised and will be discussed with you by the Gynaecologist. Your GP will be kept informed of the management plan by the Gynaecologist.

If you have any queries about cervical screening, HPV (Vaccine or testing) or cervical cancer, Dr Ian Harley can be contacted through our web site.