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Cervical Screening

Abnormal test results

About 1 in 20 women receive a cervical screening test result that shows some changes in the cells of the cervix an ‘abnormal result’ (NHS Cancer Screening Programme - Cervical screening 'The Facts' 2015).

Nearly all abnormal results show no more than small changes in the cells of the cervix. The name given to these changes is low or high grade dyskaryosis or dysplasia. Before 2011, women with borderline or low grade changes shown in their test result for the first time were asked to return for another cervical screening test in six months.  In many cases abnormal cell changes return to normal by themselves.

 

Cathy was reassured by the information she received with her abnormal test result letter. 6...

Cathy was reassured by the information she received with her abnormal test result letter. 6...

Age at interview: 43
Sex: Female
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I received a letter advising me that I needed to make an appointment. So I did right away, yes, yes.
 
And what did the letter say?
 
It said that I had had an abnormal smear and that they would like me to make an appointment to have a second one, which was a bit worrying, because it’s the first time I’ve had an abnormal smear. But the letter was quite informative and it told me the reasons why. You know, it may not be that there’s something majorly wrong, it could be just they needed to retake it. And it came with a brochure, some other literature as well. So I wasn’t too worried.
 
So the information that came with it, do you think it was helpful? Did it tell you everything you needed to know?
 
Yes, yes, it did. I’m sure there were some websites on there as well that they pointed out if you wanted further information. But it was basically the beginning of the letter that said, that kind of put your mind at rest that it’s not necessarily that something’s wrong. But you can’t help thinking the worst. But, yes, it was okay.
 
And did you talk to anybody else about this?
 
I did tell my husband, and I did tell my sister as well, because I’d never had one before, so it was quite a surprise. Because obviously at my age I thought maybe I’d have had a few by now. But, no. So, yes, I did discuss it.
HPV testing

Some types of the Human Papilloma Virus (HPV) can cause abnormal cervical cells. HPV is a very common infection of the cervix. Since April 2011, the NHS Cervical Screening Programme has been introducing a HPV triage where;

  • "If a sample taken during the cervical screening test shows low-grade or borderline cell abnormalities, the sample should automatically be tested for HPV.
  • If HPV is found in your sample, you should be referred for a colposcopy for further investigation and, if necessary, treatment. If no HPV is found, you'll carry on being routinely screened as normal.
  • If your sample shows more significant cell changes, you'll be referred for colposcopy without HPV testing (see 'The Colposcopy Examination').
  • In some areas, a test for HPV is the first test on the screening sample. In these cases, the sample is only checked for abnormal cells if HPV is found. If HPV isn’t found, you'll be offered a screening test again in three to five years (depending on your age).” NHS Choices 2015

For more information see  ‘Human papilloma virus (HPV)’ in the ‘Cervical abnormalities: CIN3 and CGIN’ section of this website. 

Receiving an abnormal test result can cause women considerable shock and anxiety, particularly when this happens for the first time, or happens again for a second time. Some of the women we talked to were frightened that they had cancer. It is extremely rare for an abnormality found at screening to be cancer nearly all abnormal results show no more than small changes in cervical cells but these act as an early warning sign that, over time cervical cancer may develop. Others were less worried because they had previously had abnormal results and regular check-ups or they had been given sufficient information to understand that their abnormal cells were not cancerous and could be treated or would revert to normal by themselves. One woman thought a mistake had been made with her test result because she thought she would feel ill if there was something wrong.

 

Kim was concerned about her abnormal test result but talking to the nurse at her GP practice...

Kim was concerned about her abnormal test result but talking to the nurse at her GP practice...

Age at interview: 34
Sex: Female
Age at diagnosis: 33
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The first result I got was the slight abnormalities one. It was a shock, I didn’t really know what to think when I got the results. It kind of threw me for six, for a little while. I got the results the day before our work Christmas party and I was kind of humming and hahing about going anyway. And I kind of got the letter the day before, and I was just, that’s it, I am not going out celebrating. If I go out, I am just going to have far too much to drink and make an absolute fool of myself.
 
I was lucky because when I got that letter, I mean it said, “We’ll call you back for a retest in six months.” And that is all it said. But I had already got an appointment booked with my nurse, and I went to see her and talked it through and said, “Well why six months? Why can’t I have the, you know, the repeat smear earlier. And she did explain about most people who have minor abnormities, after six months your body expels the virus, it fights it. It is all gone. And that is in effect what did happen to me. I mean I went back for my recall and it was perfectly all right. So she helped put my mind at rest, because I was a little nervous about it. And I must admit my nurse is really good to talk to about things like that, she explains things really well. If I haven’t had had that appointment, I probably would have panicked a bit more. But having had that discussion with her, it helped put my mind at rest and then I pretty much forgot about it, until I had to go back six months later.  
 

Describes her feelings about receiving a second abnormal test result.

Describes her feelings about receiving a second abnormal test result.

Age at interview: 54
Sex: Female
Age at diagnosis: 54
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I spoke to friends about it and some of those friends have had the experience of an abnormal smear anyway and they was okay afterwards. So yeah it was, I mean that 6 months went quite quickly and then after that I got a normal result, so that was good. And she said after that result "Come back in a year, we're not going to leave you 2 years, we will keep an eye on you, so that year make sure you come back." Which I did, that was another year that, I mean I felt quite safe but I was quite looking forward if you like to having that smear done again. So when that result come back abnormal I was quite, more choked than I was the first time really because I thought how can I get a normal one and then a year later it's back to abnormal again.

 

She was terrified when she received a borderline cervical screening test result because she thought she had...

She was terrified when she received a borderline cervical screening test result because she thought she had...

Age at interview: 40
Sex: Female
Age at diagnosis: 34
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I went for my normal smear test, not really thinking there was anything wrong until Igot letter through the door saying I'd got, they'd found some abnormalities and theywere referring to colposcopy. So I just like thought that I'd got cancer and I wasgoing to die because I'd just had this letter, this basic letter through the post. So I had a couple of days off work because I was like terrified.

Can you tell me more about that, those feelings?

It was awful it went on for quite a while I just thought you know I'd got cancer and that was it, because it didn't say anything in the letter, it just said that I'd got abnormalities and they were referring me to colposcopy. So I wasn't until I actually went for the colposcopy appointment that I felt better. And they assured me on the screen that I was just borderline and I hadn't got cancer.

 

She wasn't too concerned when she received another abnormal cervical screening test result after a period of normal tests.

She wasn't too concerned when she received another abnormal cervical screening test result after a period of normal tests.

Age at interview: 52
Sex: Female
Age at diagnosis: 46
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Well not tremendously panicky because I'd had a previous smear and I knew, positive smear, and I knew that what it was picking up was pre-cancerous cells. And I also knew that my previous smear had, the one that was positive was 95 and I'd had 3 yearly check-ups after that, cervical smears, so that whatever was there probably I'd be very unlucky if it had sort of developed into something really terrible in the intervening time.

 

Her abnormal cells returned to normal without any treatment.

Her abnormal cells returned to normal without any treatment.

Age at interview: 62
Sex: Female
Age at diagnosis: 52
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I haven't been particularly worried because I think when I went to the hospital they told me there was a school of thought that when you're going through the menopause some people do get abnormal cells which then right themselves after the menopause and that was quite reassuring because that's what seems to have happened in my case. It didn't progress, it was just one of those things and it's reverted back to being normal. And that was very reassuring actually.

 

She was shocked when she received an abnormal cervical screening test because she felt fit and healthy.

She was shocked when she received an abnormal cervical screening test because she felt fit and healthy.

Age at interview: 41
Sex: Female
Age at diagnosis: 27
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I just felt really, I suppose I was just really shocked because I was so healthy. I just, it was one of my fittest times, I was at a health club and I used to swim and walk miles and I just thought I would've known something was wrong. And I thought oh, you know they may have got it wrong.So I wasn't too worried at the time, I thought oh, the next test that I have, it'll show that there's nothing wrong. I suppose I was very optimistic in those days.

Some women received another abnormal test after several years of normal results.

 

She had a recurrence of abnormal cells after seven years and she explains how differently she...

She had a recurrence of abnormal cells after seven years and she explains how differently she...

Age at interview: 27
Sex: Female
Age at diagnosis: 20
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Oh no not again really. Just that, just frustrated really I thought will there ever be a clear one it's just, just really frustrating and not really looking forward to knowing that I might have to go through all that treatment all over again really. So I wasn't very pleased but I wasn't worried or frightened. I mean the first time that that all happened and I had treatment, the first time it's like "oh my God I've got cancer oh no" and of course it's not that at all. So because of all the things in the past when that letter came through it was like oh no not again, I really don't want to go through all that treatment again, but it wasn't the same panic and fear and thinking "oh I've got cancer" as it was the first time when I got the letters. And with the first time you know after finding I had an abnormal smear and then going back for the repeat smear, back then, that's when it was all explained "Well no you haven't got cancer, you don't need to worry, it's just abnormality, a small abnormality that can be treated very easily and it's not a problem." So after that initial first panic it was all explained and my mind was all put to rest completely. So yes with this one it wasn't that initial fear and panic it was just "oh not again". 

Other women said they felt concerned when their test results indicated a change in the severity of their abnormal cervical cells.

 

She felt terrified at learning that her abnormal cervical cells had progressed to CIN3 in a short...

She felt terrified at learning that her abnormal cervical cells had progressed to CIN3 in a short...

Age at interview: 28
Sex: Female
Age at diagnosis: 26
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I was terrified, that was it, I actually thought that you know if I, sorry from the first time I had the smear too, I don't know whether it was that day that he told me that it had progressed from the first time that I went it had progressed to the next stage and that was in, within 4 or 5 months so that was scary to me. Because I was on the last stage the next stage was cancer, that's what he had told me so it was very scary.

Waiting for a repeat test or for an appointment at a colposcopy clinic was a difficult time for many women. Some felt less anxious after reading information leaflets, or by talking to their GP or another medical professional, or speaking to family or friends who had experience of abnormal cells.

 

Speaking to a health professional reassured her that waiting for 6 months for a repeat test would...

Speaking to a health professional reassured her that waiting for 6 months for a repeat test would...

Age at interview: 31
Sex: Female
Age at diagnosis: 31
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Yes I went for my regular smear and then I was sent a letter saying that it had come back with a minor irregularity, there were pamphlets and they were explaining everything about it and reassuring notes along the lines of "This, occasionally this happens, it doesn't necessarily mean that anything is wrong but we recommend that you have another smear in 6 months and if the abnormality is still there then to seek further advice." And so I went for the second smear 6 months later.

You did, you waited 6 months?

I waited 6 months yes. Well I made some calls at the time and I discovered that really if anything were to develop it would, the advice I got was that with the kind of abnormality that I had and sorry I can't remember exactly what it was called but with the kind of abnormality that I had it would take a number of years for it to develop into anything that couldn't have anything done about it which I found very reassuring and so I, I was able to rest assured that waiting 6 months wasn't going to put me in any jeopardy, or that's how I felt given the advice that I'd been passed, had been passed to me

 

Talking to other women reassured her after she had an abnormal result.

Talking to other women reassured her after she had an abnormal result.

Age at interview: 23
Sex: Female
Age at diagnosis: 23
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No I haven't actually I was, I mean I've spoken to my mother and she, because she knows people that have had experience of things they all reassured me don't worry, you know even if it, even if there is a little something that it's probably not that major. Because I've got people around me that are very reassuring it hasn't caused a concern, I haven't you know I haven't really, I've kind of put it to the back of my mind really and in 6 months time when I go back then that's, that's when I address it. It's not, the doctor has told me 6 months you don't need to address it until then, so I've, that's exactly what I'm doing.

Feeling that they could trust the information they were being given by their GP or other medical professional was important in reducing the worry for some women. Several tried to think positively, to deal with one stage at a time and to recognise that abnormal cells could be treated.

 

Her trust in her GP was important in reducing her anxiety about receiving an abnormal cervical screening test...

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Her trust in her GP was important in reducing her anxiety about receiving an abnormal cervical screening test...

Age at interview: 52
Sex: Female
Age at diagnosis: 52
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I think may be if it had happened on my first smear I might be significantly more anxious about this. I think another really helpful thing is that I do actually have a lot of trust in my GPs generally and I really do think that if there had been anything wrong that they would have called me in and I think that's probably more significant than anything. The fact the letter was from the practice and they did give me this assurance and I did genuinely feel I could have gone in and spoken to them and that they would have given me the time, they would have given me the information I required. And that in itself was a consolation I think so I just didn't feel the need to go in, but as I say if things go wrong this time I will, even if it's an inadequate smear, I think I will ask for more advice, just for reassurance. But I'm not unduly concerned at this stage, we're not going to cross bridges before I get to them sort of thing.

 

Explains how she managed her feelings of fear when she received an abnormal cervical screening result.

Explains how she managed her feelings of fear when she received an abnormal cervical screening result.

Age at interview: 56
Sex: Female
Age at diagnosis: 55
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I suppose one half of me was saying I was, I was very frightened, the other half of me was saying no, its nothing to worry about. And those two halves were in conflict, if you like.

How do you cope with those types of feelings?

I try to be as logical as possible, and try to, try to look on the positive side, try to find out about things so okay even if it were the worst case situation then, they had said to me 'We've caught it very early then the chances of survival are very good.' So I think generally I'm a positive person so I guess I was looking more positively than, that, so I always try to do that.

For more information about what an abnormal test result means see the NHS Cervical Screening Programme’s leaflet What your abnormal result means.

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Last reviewed October 2015.

Last updated October 2015.

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