Abnormal Cervical Smear
How is a smear taken
HPV testing in a cervical smear is the basis of screening for cervical cancer and is done by scraping superficial cells from the neck of the womb with a soft brush. This is usually taken at the GP’s surgery and the sample is tested for presence of high-risk HPV.
Most smear tests are negative for high risk HPV and no further tests are required.
What is an abnormal smear
If the sample tests positive for high-risk HPV, it is then tested for abnormal cells which may be reported as any of the following:
- Borderline nuclear changes in squamous cells
- Low grade dyskaryosis (mild dyskaryosis)
- High grade dyskaryosis (moderate and severe dyskaryosis)
- Borderline nuclear changes in endocervical cells
What happens when a smear is abnormal
An abnormal smear report indicates that there are precancerous changes in the cells covering the cervix and are referred for colposcopy. The majority of these do not lead to cancer in the future.
High grade smear abnormalities, consisting of moderate dyskaryosis, severe dyskaryosis and borderline changes in endocervical cells, are referred urgently for colposcopic assessment.
Borderline nuclear changes in squamous cells and low grade dyskaryosis are referred for colposcopy on a routine basis.
Colposcopy
Many premalignant and malignant lesions on the cervix have detectable characteristics which can be identified through the colposcope. Biopsies may be taken from the cervix for examination. If the abnormality appears high grade on colposcopy, the area can be treated by a procedure called LLETZ.
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