Hello Sammyjox and thank you for posting.
It is very unlikely that cancer is a possibility in your situation.
It is easy for those of us who have nursing experience in women’s health to be less concerned about abnormal cervical screening results. However, for the general public getting any abnormal test result is a concern especially when medical terminology such as dyskaryosis is used. Given the discussion on the forum to date it may help to sum up information on cervical screening
The whole cervical screening programme is done to check for abnormal changes in the cells of the cervix, not to detect cancer. This is done so these changes can be monitored or treated at an early stage before the can develop into cancer in the future. I hope it is reassuring for you to hear that cervical cell abnormalities are very common, and treatment is easily done and very effective.
Your cervical smear detected a moderate level of abnormality (dyskaryosis) in some of the cervical cells. Colposcopy examination is done to have a closer look at the cervix and detect the area of abnormality on your cervix causing the abnormal smear. Depending on the results of your biopsies another classification system is used to describe the level of abnormality. This is called cervical intraepithelial neoplasia (CIN).
Abnormal cells are not visible to the naked eye but the colposcopy examination usually gives an indication of the level of abnormality present. Apart from micro-invasion (very early cancer) an established cervix cancer is usually visible or suspected on colposcopy. In this rare situation the biopsies are fast tracked and other tests such as scans are likely to be ordered without waiting for biopsy results to become available. A micro-invasion may only need local treatment.
In your particular case you are unlikely to have anything more serious that a moderate to severe level of abnormality. If this is confirmed on biopsy (CIN 2 – CIN 3) which often equates with moderate to severe dyskaryosis you are likely to be offered a treatment. This is usually a larger treatment biopsy called a large loop excision of the transformation zone (LLETZ).
It is also possible if the biopsy shows that the level of abnormality is low to moderate (CIN1 and 2) that you may be offered a 'wait and see' option to see if the level of abnormality resolves (reverts back to normal) itself over a period of time. There is more information on treatment of cervical abnormalities on the link here.
Treatment is very successful and more than 80% of women who have a colposcopy treatment will not need another one.
The majority of abnormal cell changes on the cervix detected by cervical screening are caused by the human papilloma virus (HPV). HPV is a common infection and it is estimated that most people who are sexually active will get HPV at some stage in their lives. Most people will have no symptoms and their immune system will clear it up in a year or two without them ever knowing they had it. Once the HPV clears any cervical cell abnormalities also clear (go away). It is possible for HPV to lay dormant (not detectable) and for some reason (maybe decades later) it is triggered to become active, so it is not possible to say when you became infected.
HPV can persist (not go away), it is not certain why some women retain HPV. We do know that women who smoke or have a defective immune system are more at risk of HPV persisting. Younger women are more likely to clear the infection probably because they have better immune systems. This is why cervical screening is not done before the age of 25. It is also why younger women (25 and under) are more likely to be offered a ‘wait and see’ option for CIN 1-2.
It is thought that by removing the area of abnormality on the cervix that the bulk of the HPV is removed. A follow up smear test is done 6 months after treatment to check that HPV has cleared. HPV is necessary for abnormal cells and for cancer to develop. But not all women who have persistent HPV will go on to develop cervical abnormalities or cancer. There is usually a long transition period from developing abnormal cells to progressing to an invasive cancer (average 10 years). In rare cases cancer can progress sooner.
Unless you are in an area in England doing HPV pilot testing only women with borderline to mild dyskaryosis are tested currently for HPV, and if positive they will be referred for colposcopy. Women with moderate to severe dyskaryosis on a cervical smear are referred automatically for colposcopy examination because of the high association with HPV. The test used in the NHS is designed to detect high risk types of HPV only. It does not detect low risk types associated with mild changes on the cervix that are unlikely to lead to cancer.
You can read more about HPV at the link here.
I can appreciate that this is a lot of information to take in. Many colposcopy teams have a specialist nurse who can give patients information and support. If this is the situation in your case it may help to contact this nurse and ask for advice in relation to your situation.
You may also find it helpful to talk things through with one of the nurses on our telephone service. The number to ring is freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.
I hope that you get your biopsy results soon.
With kind regards,