Treatment if you have abnormal cervical cells
- cervical intraepithelial neoplasia (CIN)
- cervical glandular intraepithelial neoplasia (CGIN)
What happens next if my screening test shows abnormal cells?
If you have abnormal cells from your screening test, you have a colposcopy test to look closer at your cervix. The doctor or nurse can take samples of your cervix during this test.
Will I have treatment during my colposcopy?
The colposcopist might offer you treatment at the same time as your colposcopy. Or you may go back for treatment once they have your biopsy results.
What treatment will I have for abnormal cells?
The treatment you need for abnormal cervical cell changes depends on whether you have low grade or high grade changes.
The treatment you need for abnormal cervical cell changes depends on whether you have low grade or high grade changes. Many women with low grade changes don't need treatment as the cell changes go back to normal on their own.
Your doctor or nurse might use the terms:
Your cervical screening test result
Abnormal cells are caused by the human papillomavirus (HPV). Cervical screening tests for high risk types of HPV. If this shows that you have high risk HPV, a pathologist will look at the cells in more detail. This is done under a microscope and is called a cytology test. If the cells are abnormal, you will be referred for a test called to colposcopy.
If you tested positive for HPV, but your cytology results were normal, you will be invited back for a test in a year. If in a year you still test positive for HPV, then you might be referred for a colposcopy.
Abnormal cells confirmed
Your colposcopy and biopsy results will show if you need to have the abnormal cells removed or whether they can be left alone for now. This will depend on whether your CIN is low grade or high grade.
CIN 1 (low grade)
The chance of developing cervical cancer is unlikely. The abnormal cells will often go away on their own when your immune system gets rid of the HPV. This happens in most people. You will be invited for another cervical screening test in 12 months to check whether you still have HPV.
CIN 2 or CIN 3 (high grade)
You have a higher chance of developing cervical cancer than someone with low grade CIN. The colposcopist will offer you treatment to remove the abnormal cells. This will lower your risk of developing cervical cancer.
Removing the area of abnormal cells
A few different treatments can remove the area of abnormal cervical cells. The advantage of these treatments is that the cervical tissue removed can be sent for examination under a microscope.
In the laboratory, the pathologist rechecks the level of cell changes in the piece of tissue. This ensures your screening result is accurate. They also closely examine the whole piece of tissue. This way they know the area containing the abnormal cells has been completely removed.
Treatments include:
LLETZ stands for large loop excision of the transformation zone. It’s also known as loop electrosurgical excision (LEEP) or loop diathermy. This is the most common treatment for abnormal cervical cells.
Your colposcopist uses a thin wire loop to remove the transformation zone of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.
The transformation zone is the area around the opening of the cervix.
LLETZ is an outpatient treatment and takes up to 15 minutes. You usually have it under local anaesthetic.
NETZ stands for needle excision of the transformation zone. It’s similar to LLETZ, but the thin wire the colposcopist uses to cut away the area is straight rather than a loop.
You may be more likely to have this treatment if the abnormal cells are inside the cervical canal. This is the passage that leads from the opening of the cervix to the womb.
Your doctor may suggest this minor operation to remove abnormal cells.
As with LLETZ, your doctor removes the whole area where cells can become abnormal (the transformation zone). It is called a cone biopsy because the doctor removes a cone shaped wedge of tissue from the cervix.
You usually have a cone biopsy under general anaesthetic.
In some cases, if you are past your menopause or have had all the children you want, your doctor may suggest removing the whole of your womb. This includes removing the cervix.
This is more likely if you’ve had abnormal cells on your cervix more than once. Or if the abnormality found was severe. This does not mean you have cervical cancer, but that the abnormal cells on your cervix are closer to becoming cancerous cells.
Treatment to destroy abnormal cells
These treatments destroy the cells in the abnormal area. Normal cells can then grow back in their place.
These treatments include:
Despite what the name suggests, this uses a hot probe to burn away abnormal cells.
You have it in a similar way to laser treatment, but your colposcopist puts the probe onto your cervix. You shouldn't be able to feel the probe, but you might get a period type pain while you are being treated and for a short while afterwards.
This is called cryotherapy. The colposcopist uses a cold probe to freeze away the abnormal cells.
You shouldn't be able to feel the probe on your cervix, but you might get a period type pain while being treated and for a short while afterwards.
This treatment is less common. Laser therapy is sometimes called laser ablation. This just means the laser burns away the abnormal cells. You have this treatment as an outpatient.
A laser beam is a very strong, hot beam of light. It burns away the abnormal area. You may notice a slight burning smell during the treatment. This is nothing to worry about. It is just the laser working. You can go home as soon as this treatment is over.
