What does an abnormal smear mean? Are abnormal smear results common? What causes an abnormal smear? Do abnormal cells always mean cancer? These are just some of the questions that Consultant Gynaecologist, Dr Alex Eskander and The Gynae Centre team get asked when it comes to smear test results. If you’ve had a letter telling you that your smear test has shown abnormal cells, don’t panic, says Dr Eskander:
“Smear tests do not look for the presence of cancer – they look for precancerous abnormalities in the cells that could potentially develop into cancer if left untreated. So, if you’ve had an abnormal smear result, it doesn’t mean that you have cancer.
“However, that being said, it is recommended that further investigation using colposcopy is booked in as soon as possible. Understandably, abnormal smear results create anxiety in patients so at The Gynae Centre we offer appointments within 48 hours for peace of mind if your smear results show mild, moderate or severe abnormalities.”
If you have abnormal results, you’ll either have:
Borderline or mild (low-grade) abnormalities: This means that there are some slightly abnormal changes to the cells. Your sample will be tested for HPV, and if not found, you’ll return in another 3-5 years for your next screening. If HPV is found, you’ll need to book in for a colposcopy so your gynaecologist can have a closer look at the cells on the cervix.
Moderate/severe (high-grade) abnormalities: This is when there are highly abnormal changes to the cells. In this instance, you’ll be asked to return for a colposcopy so your gynaecologist can check your cervical cells with a more thorough examination.
How common is an abnormal smear?
Around 1 in 20 women will have an abnormal smear result. Of these women with abnormal results, 1 in 2,000 will have cervical cancer.
Cervical cancer is the most common cancer in women aged 35 and under, and the fourth most prevalent female cancer. It’s estimated that in 2018 alone there were 570,000 new cases (World Health Organisation). According to Jo’s Trust, nine women are diagnosed with cervical cancer and two women lose their lives to the disease every single day.
Shockingly, 99.8% of cervical cancer cases are preventable if caught early, according to Cancer Research UK.
Dr Eskander adds: “It’s not enough to think that you’ll notice symptoms before it’s too late; precancerous cervical abnormalities are symptomless. This is why it’s so very important to have a regular smear test to pick up on pre-cancerous cells before they develop into cancer.”
Our article Everything You Need To Know About Cervical Cancer has plenty of further information on cervical cancer.
What can cause an abnormal smear?
Almost all instances of cervical cancer are caused by the human papillomavirus (HPV). Four out of five women and men will have the HPV infection at some point in their lives.
Do abnormal cells always mean cancer?
Most women whose smear tests show abnormalities do not have cervical cancer; they actually have a condition called Cervical Intraepithelial Neoplasia (CIN) and these cells, when caught early, are easily treated.
A woman’s risk of developing cancer is linked to the grade of CIN (how deep the cell changes go into the cervix). Women with CIN1 will have a very low risk of cells developing into cancer, whereas those with CIN2 and CIN3 are at higher risk.
Do abnormal cells go away?
Low grade abnormalities (CIN1) can disappear in time without any treatment.
Treatment for abnormal cervical cells
Treatment for abnormal smear may vary according to the grade of abnormality, your gynaecologist’s recommendations and your age, but it usually involves removing the abnormal cells or removing the area with the cells using large loop excision of the transformation zone (LLETZ). LLETZ involves the removal of a small cone from the tip of the cervix under local or general anaesthesia. This allows for the abnormal area to be removed so the degree of abnormality can be determined. The good news is that 95-98% of women are cured after a single treatment.
If you have any concerns about your abnormal smear test and would like to book a consultation with Dr Eskander or another of our consultants, you can call our admin team on 020 7580 8090 or book online.