Colposcopy: A Closer Look After an Abnormal Result

A colposcopy is a follow-up procedure. Your doctor may recommend one after an abnormal Pap or HPV test. It lets them take a closer, magnified look at the cervix to understand what the screening result found.

Here is the most important thing to know first. Most people who have a colposcopy do not have cancer. Screening is built to catch changes early, and a colposcopy is simply the next careful step to see those changes up close.

A colposcopy is a closer look after an abnormal result — most people who have one don't have cancer.

Pap and HPV tests are very good at flagging when something needs a closer look. But they cannot show exactly what is going on. A colposcopy fills in that picture. Your doctor may recommend one to find out whether cell changes are:

• Minor, and likely to go away on their own, or
• More significant, and worth treating early to prevent cancer

Your screening result, your age, and your past history all help decide whether a colposcopy is the right next step.

A colposcopy starts much like a Pap test. Here is the sequence:

• You lie on an exam table and the doctor inserts a speculum to see the cervix.
• A vinegar-like solution goes on the cervix, which makes abnormal areas easier to see.
• The doctor places a colposcope near the vagina to look closely. A colposcope is a magnifying instrument with a bright light.

The colposcope stays outside your body. The exam is usually not painful, though you may feel some pressure.

The colposcope magnifies the view from outside the body — nothing large goes inside.

A colposcopy usually includes a biopsy. A small sample of cervical tissue is removed and checked under a microscope. This is how your doctor learns exactly what the cell changes are.

When the sample is taken, some people feel a brief pinch or a cramp, much like a menstrual cramp. Light bleeding or discharge for a short time afterward is common. Your doctor will explain how to care for yourself and what to avoid for a day or two.

A biopsy gives the exact answer — expect a quick pinch and some light bleeding afterward.

Biopsy results are often described with the term CIN, which stands for cervical intraepithelial neoplasia. It is graded from 1 to 3, based on how abnormal the cells look and how much tissue is affected:

• CIN 1 — mild changes, which usually go away on their own without treatment.
• CIN 2 — moderate changes, often treated by removing the abnormal cells. They can sometimes clear up on their own.
• CIN 3 — more severe changes. They are not cancer, but they could become cancer over time, so they are usually treated.

Your doctor will explain your own grade and what it means for you.

CIN 1 often resolves on its own; CIN 2 and CIN 3 are usually treated to prevent cancer.

If the biopsy shows more significant changes, meaning CIN 2 or CIN 3, treatment aims to remove or destroy the abnormal cells before they could turn into cancer. These are usually simple procedures. Treating the changes early works very well at preventing cervical cancer.

Your care team will walk you through the options and what to expect. They will also cover anything special in your case, such as being pregnant or planning to become pregnant. Getting the follow-up you are offered is the key step that keeps you protected.

Treating abnormal cells early is simple and very effective at preventing cervical cancer.

• Call 911 or go to an emergency department if bleeding soaks through a pad in an hour or less and keeps up, or you pass large clots, or you feel faint, dizzy or short of breath. Blood loss at that rate needs looking at straight away, not a message left with the clinic.
• Call your care team the same day if bleeding after the biopsy is much heavier than your usual period, or you have a fever, or the discharge smells foul.
• Call your care team within a day or two if you get pain low in the belly or pelvis that is worse than period cramps, or light bleeding is still going on more than two weeks later.

Source: MedlinePlus — Colposcopy-directed biopsy.