Colposcopy

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You have been asked to come for a colposcopy because your cervical smear test has shown evidence of abnormal cells. This procedure determines the cause of the abnormalities and lets the doctor/nurse colposcopist decide if you need treatment.

Evidence of abnormal cells not unusual - about one in twelve smears is abnormal and it usually means small changes have been found in cells on the cervix (neck of the womb). These changes are known as dyskaryosis and act as early warning signals that cervical cancer might develop in the future. It is very rare indeed for these abnormalities to be cancer. For some women the changes in the cervix return to normal by themselves, other women need simple outpatient treatment that's virtually 100% effective.

Changing and cancelling appointments

It is very important to try and keep your appointment. However if you wish to change it or for any reason you are unable to attend then please telephone the Elizabeth Outpatient Department on 01895 279670. (Please note you can change your appointments only once). If you fail to attend without informing us you will be automatically discharged back to your GP. Waiting times for people to be seen in the colposopy clinic are made longer by people who fail to attend for their appointments. If you cancel your appointment this could be offered to somebody else.

Colposcopy during pregnancy

If you are pregnant when you are invited to attend the Colposcopy clinic for a First or Follow up appointment, please inform the Doctor or Nurse Colposcopist at your appointment. It is a safe to have a Colposcopy during your pregnancy, and it does not cause any harm to the baby. You may find that if you have been seen early in your pregnancy, you could also require a further assessment later in your pregnancy. Even if you require treatment, it is usually safe to wait until after the baby is born.

Human Pappiloma Virus (HPV)

Hillingdon Colposcopy Unit is a pilot site for HPV primary Screening

The cervical screening programme aim is reduce the number of women who develop invasive cervical cancer and who die from it. The screening programme has significantly helped, by halving the number of cervical cancer cases and it has been estimated that it has saved on average 4500 lives per year. Women aged 25 – 64 are eligible and currently screening is every 3-5 years.

What is the Human Papillomavirus (HPV)?

There around 100 types of HPV. Most do not cause significant disease in humans; however some subtypes mainly 16 and 18 have been confirmed as agents causing cervical cancer.

Almost all cancers contain High risk (HR)-HPV DNA.  Evidence suggests that women who do not have HR-HPV are very unlikely to develop cervical cancer.
HR-HPV infection is very common. In most cases, infection is transient and is cleared by the woman’s immune system. There are a small percentage of women 20-30%, for reasons that are unclear, do not appear to clear the virus and this is the group who is most at risk.

Most cases are of the HR HPV are sexually transmitted between men and women and same sex partners.

HPV primary screening

This means that the HR-HPV test is the first test performed on the cervical screening sample. The Cytology (smear test) then become the triage test and is only performed if the HR-HPV test confirms HR-HPV to be present.

Using HR-HPV testing has several benefits, it is more sensitive in detecting high grade CIN than cytology (smear test) and this may potentially allow women to be screened less frequently in the future.

Women in Hillingdon will be part of the primary cervical screening pilot. If they receive a negative HR-HPV result they will return to routine recall and their next test will be in 3/5yrs.

Women who test positive for HR-HPV will have a cytology (smear test) performed. If this cytology (smear test) shows abnormal cells they will be referred for a colposcopy examination.

Pilots of HPV primary screening are now underway, with Hillingdon Hospital once again being part of the six centres across England in assessing how this approach could be used across the screening programme as a whole.

Further information

If you have any questions/queries before you attend, please do not hesitate to contact our Nurse Colposcopist. This is a teaching hospital, sometimes student doctors/nurses may be present during your clinic appointment. Although attending these clinics is part of their training, it is your choice if you do not wish them to be present. Whatever your decision, your treatment and the standard of care you receive will not be affected.

Patient information leaflets are available in our Outpatient Department.

Links for further information:
NHS Cervical Screening Programme
The British Society for Colposcopy and Cervical Pathology
Macmillan Cancer Support
Royal College of Gynaecologists and Obstetricians
Cancer.answers.com
Jo's cervical cancer trust
HPV vaccination: What is HPV?
NHS Choices - Cancers and Treatments
Macmillan Cancer Support - Cancer Information
Nurse taking blood pressure of a seated man

Colposcopy
Main building, Elizabeth Outpatients (3rd floor)
Hillingdon Hospital
Telephone: 01895 279670
Colposcopy Co-ordinator