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Abnormal cervical smears

In England all women between the ages of 25 and 65 should have a cervical smear. Your General Practitioner surgery will have a recall register to contact you when your next smear is due. Usually women have a smear test every three years but this may be more frequent in certain cases. 10% of all smears show an abnormality that require referral to a gynaecologist.
A cervical smear is not a test for cervical cancer. Smear tests are used to detect changes on the skin over the cervix which are pre-cancerous (called Cervical Intraepithelial Neoplasia or CIN). These changes are thought to be caused by the Human Papilloma Virus (HPV), which is very common in women of the reproductive age. There are different grades of CIN (1, 2 or 3) and not all need treatment. By the early detection and if necessary treatment of CIN the number of women dying from cervical cancer has fallen considerably since the introduction of the cervical screening programme.
Very minor abnormalities can be monitored and sometime your GP may recommend you have a smear test repeated in 6 months time. In many cases of abnormal smears your GP will recommend you be referred for a colposcopy. This is usually done by a gynaecologist, and involves an examination of the cervix with a microscope. This is done in an outpatient setting and is no more uncomfortable than a smear test and usually only takes about 20 minutes. Sometimes a biopsy needs to be taken if the examination shows CIN, which usually only causes minor discomfort. If CIN 2 or 3 is confirmed and small treatment performed to remove the abnormal cells. This is done in the outpatient department and only takes about 20 minutes.
Following treatment you will need regular smears and your gynaecologist will inform you of how often these should be. Liquid based cytology (LBC) is a new and improved cervical smear test. This is now available privately and is being introduced routinely into the NHS screening programme.