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Cervical Screening

Being referred for colposcopy and treatment

We talked to women about how they felt about being referred for a colposcopy examination. Many said they felt anxiety, fear and panic (see 'Abnormal test results'). Only very rarely will the biopsy taken during this examination show that cell changes have already developed in to cancer.

The colposcopy examination allows the doctor to see the type and area of the abnormality on the cervix. A magnifying device, called a colposcope, is used to examine the cervix and to see the area of abnormal cells more clearly.The colposcope does not go into your body. A small sample of the abnormal cells (a punch biopsy) may also be taken during the examination to assess the stage of the abnormal cells. The colposcopy and biopsy enable doctors to assess whether the cell changes are Cervical Intra-epithelial Neoplasia (CIN). CIN means abnormal cells found on the surface of the cervix. The cell changes can be classed as  CIN1, CIN2 or CIN3. This classification is used to indicate how far from the surface of the cervix the abnormality extends

Treatment is usually given to remove CIN2 or CIN3 abnormal cells. It is done in the outpatient colposcopy clinic, sometimes the same time as the examination. 

Several women we interviewed said that it was the waiting that was the worst part of their experience. Waiting for test results, or waiting for treatment was a very anxious time, especially when it took place over several months.
 

Waiting times in between appointments and for results was one of the hardest things to deal with.

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Age at interview: 32
Sex: Female
Age at diagnosis: 31
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I think one of the worst things is the waiting times in between everything. So you get your letter saying you have got something wrong with you. You have got to go in. So you have got to wait for them few weeks to go in. Then you go in and they take a biopsy. Then you have to wait for the results of that. So, you go through another week where you are waiting for the results. And then I was told that, you know, I had to have to more treatment, so I then had to wait for that and then you have the treatment and then you have to wait again for the results of that to confirm that it was only at the stage that they said it was.
 
And then you get through all that and you are like, ‘oh my goodness thank goodness it is all over.’ I haven’t got to worry about it all now for another six months. And then you get to kind of like February, I got to February, March of this year and I started to think I have got to go back for my appointment again in a few weeks time. So you start worrying again about that.
 
And then you have a smear test and again you have to wait again for the results of that and I think lots of people have said that the worst part is the waiting. And you know, the periods in between when you are waiting is when you kind of just think, well is everything okay and why has it happened. And you know, it can get really difficult. But the worry and the waiting is definitely, for me, was the worst part. The mental part was a lot worse then actually going through the physical procedures of having the colposcopy done, having the LLETZ, having the cone biopsy done. Even I know there is so many people that don’t like going to have smear tests and that all pales into significance when you are just waiting for results. That is the hardest, hardest thing.

Many women felt very anxious and nervous before their colposcopy appointment particularly if they had waited a long time for their appointment.

 

She felt very anxious waiting for her colposcopy appointment.

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Age at interview: 31
Sex: Female
Age at diagnosis: 31
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The first 6 month wait was quite concerning to me because may be I'm a hypochondriac but I just had all these other things going on that made me think that something was going to be wrong. The second 6 months was a little bit worse but not unbearable. My feeling about the second wait really was that if the doctors, if my doctor or the system that follows up on cervical smears felt that there was anything more urgent that I would probably be being dealt with faster. And certainly when I rang to re-make my appointment with the colposcopy clinic having missed the first one due to mail mix up they, I do recall in that conversation commenting it's taken so long I don't want to wait another couple of months. And reassuring voice saying that the length of time the appointment had been set for was an indication that the feeling of, the feeling towards my particular circumstances were that you know there was nothing to panic about. So everybody has been very reassuring along the way but it strangely hasn't made too much of a difference to the way I've been feeling about things and I was worried going into it.

 

Talking to the colposcopy nurse on the telephone reassured Paula while she was waiting for her...

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Age at interview: 32
Sex: Female
Age at diagnosis: 31
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I just went for my routine smear test in July last year. And then about four weeks after I had my smear test, I had a letter come through which said I had severe dyskaryosis. I didn’t know what that meant at the time. But I was obviously worried at what that meant, because there was a leaflet in there with it and just sort of said that there was some cell changes and they needed to have a closer look at what the changes were. So they invited me to Colposcopy, which I think, the appointment was about two or three weeks after I had the letter.
 
So I went to the Colposcopy clinic. Prior to going to the Colposcopy clinic I was really, really worried about what was going to happen and I was worried about the whole procedure because there was a leaflet in there saying they might do treatment there and then, if they find any abnormal cells.
 
So I actually phoned the Colposcopy nurse at the hospital before I went and she was really good. She had a chat with me on the phone. Told me exactly what was going to happen if they found the cells and how they would deal with it. So I felt a little bit more reassured after speaking to her, but I was very frightened at the time.

At the colposcopy examination, “The doctor may be able to tell you what is wrong and what treatment, if any, is needed. But often, especially if you have had a biopsy, you will not be given a definite diagnosis immediately after the examination. It will take a week or two before you get the results of the biopsy.” - NHS Cancer Screening Programmes - The colposccopy examination' 2012.

Women we interviewed who were told that the changes shown in their screening test were due to infection or inflammation said they felt relieved. Others were worried when they were told that they had CIN2 or CIN3 which needed treatment. One woman who had been having colposcopy examinations over a period of many years said it was only when she was told that she needed treatment that she felt fearful that she might have cancer, which proved not to be the case.

 

Describes how she felt about her diagnosis at the hospital following further investigations of...

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Age at interview: 48
Sex: Female
Age at diagnosis: 48
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No I was, I came out feeling quite relieved and phoned my husband even before I left the hospital building. In fact I think he phoned me and gave him the news that it was probably absolutely fine. And he was pleased, and said "You see, I told you it would all be fine, are you alright?" And I said "Well I'll still be happier once I've got the result." And he said "Well I think you'll find it's going to be okay. No emotionally I was pretty much okay then, I came out and I drove to the nearest large shopping precinct and did some shopping as you do. I was told at the time I would probably have a two to three week wait I believe for the result. I think that was the time scale. But in fact I had the results within about eight to ten days, it was very fast and it was very clear in saying you know there really wasn't a problem and that I should have another smear with my GP after a year.

 

She felt relieved about her diagnosis but a little anxious until she received her biopsy results.

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Age at interview: 37
Sex: Female
Age at diagnosis: 36
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They just said that, they said that they didn't think there was anything to worry about, I didn't, there weren't that many abnormal cells and that, obviously it has to go to the lab and everything and then he said that the results would be back within two weeks and to contact my own GP.

Immediately after that treatment how were you feeling?

I was sort of relieved a little bit because I thought well if the doctor says that it's not that bad then it can't be that bad. And, but then I was a little bit on edge still because obviously you want to know what the actual results are but I didn't feel quite as bad.

Many women said that the experience of having abnormal cervical cells and being referred for colposcopy and having treatment had been a very emotional experience. Some women were very up and down or had felt depressed at times. Others talked about the worry they experienced and how it was easy to let their imagination run wild.

 
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Waiting for a hysterectomy and worrying about her results made Laura feel very depressed.

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Age at interview: 39
Sex: Female
Age at diagnosis: 37
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I’m on anti-depressants anyway from having this. I was so depressed before Christmas that I felt like, because it was such a long time from, it was November to January. And they don’t do treatment over Christmas because you can’t have sex for six weeks. They don’t like to spoil your Christmas. So I had to wait all that time. And I was so depressed. I went to my doctors and she put me on antidepressants. And I don’t think, to be honest, I know I wouldn’t have coped without being on those, because I was so down. And it is like they say, these tablets that you take, just lift you and get you back, just to normal. It is not something I would not tell people because you can’t help it if you get depressed. But yes, I think it has helped me an awful lot getting through, you know, just feeling so down, and worrying about it really.
 
So you were really worrying about having the…?
 
Yes, it was just the waiting. It was, you know, from having, I was just thinking if I’ve got CIN3, how can they leave me? Because it was March before they actually, they couldn’t get me in any earlier because I tried, and I kept thinking if they are going to leave [me] from, because it was December to March. Is it going to get any worse in that time? And obviously the reason they gave me the hysterectomy six weeks after the biopsies, you have to heal for six weeks.
 

Kim felt frightened, worried and had days when she felt down during investigations and treatment...

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Age at interview: 34
Sex: Female
Age at diagnosis: 33
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What were the main emotions that you had?

 

There was a lot of fear. You know at the back of your mind that they are probably not going to find any major, but there is always the what if? There was a lot of anxiety, as well, which I think, it is naturally coupled with the fear. And generally a feeling of just being down a lot of the time. Just not really feeling like yourself I think is the best way to describe it. Because you have got these thoughts niggling at the back of your mind and they won’t go away, until, you know, because you need the closure. And you can’t have the closure until you have had the procedure and got the results. So there is the anxiety, there is lots and lots, I think. It’s really hard to describe a lot of them, because I think, again, it is very personal, like some people they will be fine, and they won’t worry about. They’ll just carry on, and like I said before, I was a bit mixed. I had days when I was absolutely fine and days when I wasn’t. There is also, not knowing, you are going into something totally new to a certain extent, which is why with my friends I am more than happy to talk to them about it, so that they have got someone’s experience to take them forward to kind of let them know what they can potentially expect. And I think that helps, because when I did it, I had people I could talk to on internet forums, but it is not quite the same as having a face to face discussion.  
 

Paula was very scared and at times during treatment she worried that her abnormal cells might...

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Age at interview: 32
Sex: Female
Age at diagnosis: 31
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I was very scared. The time from sort of getting the smear result back, to then getting the all clear in the October. So it was probably like a two month turnaround from abnormal smear to LLETZ to cone, to it all okay. That two months was really hard, because my sister also had cervical cancer four years ago. She is absolutely fine now, she had a hysterectomy. Obviously because that happened to her and then I had the abnormal cells, I was very, just sort of oh, you know, the chances are it might be the same as what happened to my sister. But it wasn’t, it was fine. But it was very it was a really difficult time because you just find sometimes your mind goes on overdrive and you think oh what if it not just pre cancerous. What if it has gone further and it was a pretty difficult time. But as I say it was two months turnaround and happily it was all okay.

For more information see ‘Cervical abnormalities: CIN3 and CGIN'.

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Last reviewed October 2015.

Last updated October 2015.

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