Cervical abnormalities: CIN3 and CGIN

Follow-up care

Many of the women we interviewed talked about having follow-up care a few months after treatment. A colposcopy and cervical screening test (smear) are usually performed 4 - 6 months after treatment. Further follow-up may be advised once the results of colposcopy or / and cervical screening tests are received. Usually this involves regular cervical screening tests for a set time.

Most of the women we talked to were pleased to have follow-up care because they felt that, if abnormal cells were found again, they would be treated early. Many were unsure when their first follow-up appointment after treatment would be, how regular these appointments would be and what they would involve. Some were also unsure whether and for how many years they would be seen at a hospital or at their local surgery. Several women said they would have liked more information about follow-up care.

Many of the women we spoke to had their first follow-up appointment six months after treatment and the second six months later. They then had annual appointments for ten years, which involved having a cervical screening test (smear). A few women had colposcopies at the hospital as well as cervical screening tests at their GP surgery.

Women often felt reassured that they were being monitored annually and said they would feel uneasy about being screened every three years on the NHS Cervical Screening Programme. Others, who’d had clear results for some time, were now back to 3-yearly screening.

Many of the women we talked to felt anxious before their follow-up appointments, especially the first one, in case further abnormalities were found. One woman was unsure whether she’d need more treatment at her first follow-up appointment. Sandra was told that her results were clear after treatment but, at her first follow up appointment, she was disappointed to be told that she’d need more treatment.

Some of the women we interviewed said they were concerned about having a recurrence (see ‘Recurrence of abnormal cells’). Michelle's anxiety was exacerbated by media coverage of reality TV star Jade Goody’s experience of cervical cancer. Jane had been so anxious about having a recurrence that she missed two follow-up appointments in case abnormalities were found. Patricia worried so much about a recurrence before each follow up cervical screening test (smear) that she decided to have a hysterectomy.

Treatment for CIN is very effective and, in most cases, successful first time. A few women, though, did have a recurrence, which was found at follow-up. They were treated again, usually by LLETZ (see ‘Recurrence of abnormal cells’).
Women still need follow up if they have had a hysterectomy for abnormal cells (see ‘Hysterectomy’). The cervical screening test (smear) will be taken from the top of the vagina, near where the cervix was. This is called a ‘vault smear’. Very rarely, the abnormal cells can come back in this area, so women are offered cervical screening tests six months and one year after a hysterectomy. If everything is fine, no further cervical screening tests are needed.

HPV as a ‘test of cure’
The NHS Cervical Screening Programme is introducing an HPV ‘Test of Cure’ for women who have undergone treatment for cervical abnormalities (CIN 1, 2 or 3). When women return for follow up screening, four to six months after treatment, if the test shows normal, borderline or mild screening results, the sample will also be tested for HPV. If HPV is detected or the screening test shows an abnormality, women will be referred again to colposcopy. If the screening result is normal and the HPV result is negative, women will return to routine recall for cervical screening every 3 years. This new policy aims to reduce the need for up to ten years of annual cervical screening.

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Last reviewed July 2017.
Last updated July 2017.


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