Cervical abnormalities: CIN3 and CGIN

The colposcopy examination

Colposcopy is a simple examination that allows the doctor to see the type and area of the abnormality on the cervix. It also lets the doctor decide if treatment is needed. It is a diagnostic procedure used to help find abnormal areas of the cervix (CIN) as early as possible. It involves using a magnifying device, called a colposcope, to look at an illuminated, magnified view of the cervix, the tissue of the vagina, and vulva. Colposcopy is not a treatment, but treatment can take place at the colposcopy appointment.

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Most of the women we spoke with had never heard of CIN or of ‘colposcopy’. Some were sent information about the examination with their cervical screening results, while others had looked for more information on the internet. Anna, who was travelling abroad when she found out she’d been referred for colposcopy, had found very little information in English, making this an extremely worrying time.

Some of the women we interviewed received an appointment shortly after getting their results letter and felt pleased and relieved that they wouldn’t have to wait long to find out what was wrong. Those who did have to wait, though, were often anxious and some worried that the abnormalities could be progressing. A few women, who were particularly concerned about waiting for their appointment, decided to have private care so they could be seen quicker.

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Some of the women we talked to hadn't known what to expect when they went to the colposcopy clinic and felt very anxious. Several went alone, while others found it helpful going with their partner, mum or a friend. With hindsight, a few recommended going with someone who could help them to remember what the doctors told them. Many said they worried more than necessary because the procedure turned out to be quick and painless.

Some of the women we interviewed recalled what happened when they arrived at the clinic. After giving information about their medical history, they were told about the colposcopy examination and what would be involved.

Most of those interviewed described the procedure as similar to a cervical screening test (smear) and said it was painless. Several said that, although they felt embarrassed or undignified because they had to undress and have their legs up in stirrups, they knew the procedure had to be done and they were glad it was quick. One woman said she took a paracetamol before her colposcopy appointment and felt no pain at all. Many said that the nurses or doctors were very reassuring. They talked to them throughout the procedure and did their best to make them feel comfortable. Solutions of iodine and acetic acid are applied to the cervix, which are used to highlight the abnormal cells on the cervix. Women said this part of the procedure was not painful.

A punch biopsy is a small biopsy that is taken at the time of a colposcopy examination. The biopsy shows the type of abnormality present. Some women do not feel anything when a punch biopsy is taken, while others experience a little discomfort during and / or after the biopsy.

Some of the women we interviewed felt that the colposcopy appointment was rushed, that they were given very little information, and had no time to ask questions. Sam, who was 21 at the time, had several colposcopy appointments over one and a half years and said she would have liked more information about why these were needed. 

Some of the women we talked to were treated for CIN3 at the same appointment as their colposcopy, while others were given an appointment for treatment at a later date (see ‘LLETZ). One woman was told she had CIN3 and a small amount of cervical cancer, and was treated there and then by LLETZ.

Two women said that doctors suspected that, as well as CIN3, they could have cervical cancer but they would only know after getting the colposcopy results. Melanie was told she had CIN3 but, a few weeks later when doctors got her colposcopy results, they found out that she had cervical cancer.

After a colposcopy examination some women experience a heavier and sometimes more painful period than usual, or find that their periods begin earlier or later than expected. Usually these symptoms settle down quickly without medical attention.

More experiences of the colposcopy examination can be found on the Healthtalkonline - Cervical Screening site.

If you have had treatment for cervical abnormalities/CIN (such as a colposcopy, LLETZ or cone biopsy), you will be asked to go back after six months for more screening. The NHS Cervical Screening Programme has introduced a ‘HPV test of cure’ programme which means that the sample taken at this screening will be tested for abnormal cell changes (CIN) and it will also be tested for the HPV virus. If the screening result shows either the HPV virus or abnormal cell changes;

‘You will be invited back for colposcopy again to see if more treatment is needed. If no HPV is found, you can go back to regular screening every 3-5 years depending on your age.’ (NHS Cervical Screening Programme 2014)

‘HPV test of cure’ is available in England, Northern Ireland and Wales. This programme is not currently operating in Scotland.

 

Last reviewed May 2014.

Last updated May 2014.

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