Colposcopy (Cervix Examination)

A call saying your Pap smear was abnormal, or that you tested positive for HPV, is frightening. It helps to know what it usually means. Some cells on the cervix look changed, most often because of an HPV infection, and they need a closer look. It very rarely means cancer.

Colposcopy is that closer look. You lie as you would for a Pap smear, and the doctor examines your cervix through a colposcope, a magnifying instrument with a light that stays outside your body. Dilute vinegar (acetic acid), and sometimes an iodine solution, is dabbed on the cervix. Abnormal areas turn white with the vinegar or don't take up the iodine stain. If an area looks abnormal, a tiny sample (biopsy) is taken.

Most colposcopies find either a normal cervix or mild changes that go away on their own. When higher-grade changes are found, they can be removed with a simple day procedure, years before they could turn into cancer. This is how cervical screening prevents most cervical cancers.

Colposcopy, Pap smears and pelvic ultrasound are all available in-house in our gynaecology department, and a female nurse or attendant is always with you during the examination. Biopsies are processed by our diagnostic department.

Colposcopy follows up a screening result or a symptom. It's usually advised for one of these reasons.

If no biopsy was needed, the doctor can often give you the findings straight away. Biopsy results usually take about a week and are graded as CIN (cervical intraepithelial neoplasia). CIN1 is a mild change, CIN2 moderate and CIN3 severe. These are precancerous changes, not cancer.

CIN1 usually clears by itself within one to two years as your immune system gets rid of HPV, so it's normally watched with repeat tests. CIN2 and CIN3 are usually treated, most often with a LEEP (a thin wire loop that removes the abnormal area under local anaesthetic) or by destroying the area with cold or heat. In younger women, CIN2 is sometimes watched closely instead, after a discussion with you.

Rarely, the biopsy shows cancer. Found this way, it's usually at an early stage, and your gynaecologist will explain the next steps, which may include referral to a gynaecological cancer specialist. Whatever the result, you'll be told when your next Pap or HPV test is due.