Abnormal smear test

Specialty of Genitourinary Medicine

What does it mean if your smear test results are abnormal?

If you have an abnormal smear test result, this does not mean you have cancer. Instead, you have some changes in the cells of your cervix. Depending on how abnormal these changes are, there is a potential for these cells to develop into cancer in the future.

Some types of abnormal result will not need treatment, whereas others may require follow-up tests and treatment. It depends on the type of result you get:

Low grade changes – these involve minor changes to the cells in your cervix. It has been shown that around half of low-grade and borderline changes return to normal without treatment, so for these types of changes your doctor will usually recommend a HPV test rather than treatment. If the test shows a high risk of HPV, you’ll need a colposcopy to investigate further.

High-grade changes – this can involve from 2/3 to all of the lining of the cervix having abnormal cells. If left untreated, these cells have a high potential to turn into cancer. Therefore, if high-grade changes are detected you’ll be invited to have a colposcopy for further investigation and treatment.

How are abnormal cells treated?

There are a number of ways to treat abnormal cells in the cervix, depending on where they are and the type of abnormal cells you have. The main treatments include:

  • Cone biopsy – this is a procedure performed under general anaesthetic and involves removing a cone of tissue from your cervix to take away the abnormal cells
  • Cryotherapy – this involves using a cold probe to freeze and kill the abnormal cells
  • Laser ablation – this is a targeted treatment which is aimed at the abnormal cells to kill them
  • LLETZ procedure – this is a procedure performed under local anaesthetic and involves a small electrified wire which is used to cut away abnormal tissue

Generally, these treatments will not have an effect on your fertility, and you should be able to return to work after a couple of days. Treatment is in most cases highly effective, and should remove all of the abnormal cells. Recurrence rates for abnormal cervical cells are around 5-15%.

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