Abnormal Smear or Dyskaryosis?
See a Consultant
This Week

Almost always, no. An abnormal result usually means high-risk HPV has been found, or that early changes have been seen in the cells of your cervix. These changes are pre-cancerous rather than cancerous, and many resolve on their own without treatment. Screening exists specifically to find and treat these changes long before they could ever become a problem. Your consultant will go through your individual result and explain exactly what it does and does not mean.

HPV, or human papillomavirus, is a very common virus that most sexually active adults will come into contact with at some point in their lives. Testing positive for high-risk HPV does not mean you have done anything wrong, and it does not mean you will develop cervical cancer. In most cases the immune system clears the virus on its own within around two years. Where it persists, it can cause changes to the cells of the cervix, which is why follow-up matters.

A colposcopy is very similar to having a smear taken. You lie on a couch, a speculum is gently inserted, and your consultant uses a colposcope, a magnifying instrument that stays outside your body, to look closely at your cervix. A liquid is applied that makes any abnormal areas easier to see. The whole appointment usually takes 15 to 20 minutes. If a small tissue sample is needed, it is taken at the same time.

Most women describe a colposcopy as uncomfortable rather than painful, much like a smear test. If a biopsy is taken you may feel a brief pinch or a period-like cramp. Some light spotting or a dark discharge afterwards is normal and settles within a few days. Taking a simple painkiller beforehand can help. Tell your consultant if you feel anxious about the examination, as it makes a real difference to how the appointment is handled.

LLETZ stands for large loop excision of the transformation zone. It removes the area of the cervix containing the abnormal cells using a fine heated wire loop, under local anaesthetic. It takes around 15 minutes, you go home the same day, and it successfully clears the abnormal cells in the great majority of women. The removed tissue is also sent to the laboratory, which confirms the diagnosis at the same time as treating it.

A single LLETZ treatment does not affect your ability to conceive. Where a larger or deeper area of the cervix is removed, or where you have had more than one treatment, there can be a slightly increased chance of a baby arriving early in a future pregnancy. Your consultant will factor your plans for pregnancy into the treatment recommendation and will talk this through with you before anything goes ahead.

Biopsy results usually come back within around one to two weeks. Your consultant will contact you to go through them and explain what they mean and what happens next. You see the same consultant throughout, so you are never repeating your story to someone new.

Most patients are offered an appointment within 48 hours of getting in touch. No GP referral is needed. You can book directly by phone, email or by completing the form below. Bring your screening result letter with you if you have it.

No. You can book directly as a self-pay patient without a GP letter or referral. If your insurer requires a referral for pre-authorisation purposes, our team can help you arrange that.

We work with all major UK private health insurers including Bupa, Aviva, Vitality, WPA and Cigna. Please bring your membership details and any pre-authorisation number when you attend.

Low grade means mild changes in the surface cells that often return to normal without treatment, whereas high grade means moderate or severe changes that are less likely to clear on their own and are usually treated. Neither is cancer. Both are checked with colposcopy and the biopsy taken at that visit is what decides whether treatment is needed.

Not usually. Dyskaryosis is found by screening precisely because the changes don’t cause symptoms, which is why keeping up with smear tests matters. Bleeding between periods, after sex or after the menopause and pelvic pain are not symptoms of dyskaryosis however, they should always be looked into in their own right and we can see you for both at the same appointment.

Low. High grade dyskaryosis is a pre-cancerous change and in the great majority of cases the biopsy confirms CIN2 or CIN3, not cancer. A small number of women with a high grade result are found to have early cervical cancer at colposcopy, which is exactly why these results are seen quickly and why treating CIN matters - it removes the changes before they have the chance to develop further.

Very rarely. A smear suggests a grade but it’s the biopsy that confirms it and now and then a low grade smear shows a higher grade on biopsy. That’s the reason a colposcopy is offered even for low grade changes when HPV is present - it rules out anything more significant so you and your consultant can agree on watchful monitoring with confidence.

In England this combination is referred for colposcopy. Your consultant examines the cervix and takes a biopsy if anything looks more than low grade. If low grade is confirmed the usual plan is no treatment and a repeat smear with HPV test in 12 months, because most of these changes clear on their own once the body deals with the virus. We can do that repeat test privately if you’d rather not wait for the NHS recall.

Usually many years, if at all. Most dyskaryosis never progresses and where it does, the move from high grade changes to cancer is typically slow, which is why screening every 3-5 years works. It is not something that changes in the weeks between your letter and your appointment, so there is time to be seen properly without rushing a decision.

Colposcopy is routinely carried out in pregnancy and is considered safe, so it is often used to check high grade changes so a plan can be made. Treatment is normally postponed until after the birth unless there is a concern about cancer, because LLETZ in pregnancy carries a higher risk of bleeding. If you’re pregnant and have had an abnormal result, tell us when you book so the right consultant sees you.

Yes, in practice. Dysplasia is the older term and the one still used in the US whereas dyskaryosis is the term UK laboratories use for cell changes seen on a smear. Both describe abnormal but non-cancerous cells and both are graded from mild to severe.