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What happens when it’s an abnormal smear test

So you went for your smear test, got the letter in the post a few weeks later with your results and… there’s a problem. I hope yesterday’s post has show that statistically, things are in your favour. But what happens if you do have an abnormal result? This happened to my friend Jade a few years ago. I asked her to write a post for the blog:

Love this picture of Jade from earlier this year.

“It was just a routine smear test, I didn’t think anything of it at all. I’d never had a problem and felt fine before the test. Then I got the letter. It said that I had ‘abnormal’ cells and asked me to call ‘urgently’. That did make me a bit scared, I rang and the clinic asked me to come in to see them in two days time. I was pleased that they responded so fast but at the same time, felt really anxious — what if it was serious? I mean the NHS aren’t always so quick!

So, when I went in, I saw a specialist who examined me, she told me that I had prominent areas of abnormalities…  I did get a bit upset then, but she sat me down and explained everything to me. My specialist said that she wanted to treat me there and then with a LLETZ. I was encouraged to take some time to read through a leaflet which explained everything about the procedure and then ask questions.

Basically, a LLETZ is a ‘large loop excision of the transformation zone’ which sounds way more complicated than it actually is. The ‘transformation zone’ is the bit of me that had the abnormal cells and the ‘large loop excision’ is a what they were going to use to get rid of them.

I’ve probably got an average pain threshold and it really didn’t hurt. I think the idea of it was a lot worse than the reality. The specialist applied an anaesthetic gel to my cervix and that meant that I didn’t feel any of the injections that I got ‘up there’! Really – it was just a bit uncomfortable. It was all over pretty quickly as well. There was a smell of burning, which they’d warned me about, but was still pretty weird, apparently that was from a procedure that helps stop any bleeding.

One of my main concerns was that I’d heard that the procedure could affect me having children, but I was reassured that it would be OK.  I could walk and sit down afterwards, I was so surprised that it didn’t really hurt – I was more emotional than in pain. I think, as a women, it was an emotional experience to go through, but I talked to friends and my partner, and it helped so much to know what was going on.

That was five years ago.

I have yearly smear tests since – and they’ve all been fine. I’ve never had any problems since. I’d gone from a normal clear smear to three years later discovering that I had what they call ‘CIN2’ moderate cell changes which, if left untreated could leave me at a high risk of cervical cancer. There were no signs at all, maybe just a bit of occasional discomfort with sex but not always, so I didn’t think anything was wrong. That test could have saved my life. I’d say to any women who miss their smear test, you’re crazy not to go.”

Find out more: Get good info, get informed, get tested…   

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Smear test recall: what do the results mean?

Just relax if it's a recall.

It’s the day that you’ve been waiting for… statistically, you’re likely to receive the all-clear, with 93.5% of women receiving a clean bill of health. But there’s still no need to be alarmed if you get a recall. I spoke with an NHS spokesperson to get the low-down.

It’s a recall:
You might get a recall as the sample was inadequate. Thanks to better testing nowadays, that’s quite a small percentage, around 2.8% were recalled in 2009-10. All that means is that the your sample did not show up clearly. You will need to call and re-book and repeat your smear test and the result letter will indicate when the next test should be taken.

It says it’s abnormal:
Don’t panic! If you get an abnormal result all that means is that the laboratory has identified that some of your cells may need investigation. You may be asked to go in to repeat your smear test, perhaps in three or six months, because the abnormal cells may return to normal. They’re basically keeping an eye on you to make sure any abnormalities don’t turn into anything to worry about. You may even receive three ‘borderline’ results before you’re referred to the Colposcopy department, which is where you receive a closer examination, (the procedure is called Colposcopy). So don’t worry, just remember this a pre-cancer screening programme, not a test for cancer.

HPV triage testing:
Currently six areas in the UK are using HPV triage testing. This means that samples showing borderline or mild changes are tested for the high risk HPV and those who test positive for HPV are referred to Colposcopy. This has been very well-evaluated, and will be rolled out across the whole UK over the next year. This will speed up the process of those who need to go for further treatment and those who don’t. HPV testing will also include a ‘test of cure’, following treatment for abnormal cells, if the HPV test is negative this allows women to be returned to the normal screening intervals much more quickly.

This is a colposcope

Colposcopy:
This is a further examination. Cervical cancer is rare in the screening programme and only represents 2 in 10,000 women screened. If you get a moderate or severe result in your smear test, you’ll be referred straight to the Colposcopy department. Colposcopy is a procedure that’s similar to a smear test. You still have a speculum put inside you, but your nurse or doctor will use a colposcope to look at your cervix. The colposcope magnifies your cervix so that the nurse or doctor can really see what’s going on. The doctor or nurse will also apply a diluted vinegar solution to your cervix – acetic acid – which helps to show up any abnormalities. At this point, if they believe that you have severely abnormal cells, they make take a biopsy to confirm the diagnosis or they may suggest treatment immediately.  Again, don’t panic! Your healthcare providers will explain everything to you. All the treatments that you may be offered aim to do the same thing, get rid of the abnormal cells so normal ones will grow in their place. You’ll be able to have the treatments under a local anaesthetic and go home straight after treatment.

Find out more:

There’s some great detail and help here if you want to know more about the different kinds of treatment available to get rid of abnormal cells. Also, a reminder on what is HPV and how does it cause cervical cancer?