Cervical Smears, Abnormal Results and a Colposcopy

I have been meaning to sit down and write this post for months, but there is always something that comes along and gets in the way of what I want and need to say. So now with Leo back at school, I thought I would sit down with a cup of coffee, and bring this here blog up to speed with my YouTube channel (It would mean so much if you could hit the subscribe button while you're over there!)

A few months ago I posted two very personal videos to my channel (I will add them both into this post in case you want to see what I said). The videos followed me as I prepared to go along to my GP for my very first Smear Test, which for those of you who don't know, is a test that helps detect abnormal cells on the cervix. 

I am going to go into as much detail as I can in this post, because when I found myself taking to Google, I always found myself on websites relating to the dreaded 'C' word, and I want to offer my personal experience here, and try to help anyone who is currently worrying about an abnormal smear test result.

Women in the UK are invited for a Smear test from the age of 25 years old, and being 27 I was a few years late in booking up and going along. It was something that I admittedly put off and off, it never seemed to be an urgent task for me to comply with, because let's face it... Who wants to go along and expose themselves in such a vulnerable way to a complete stranger?

Even though I had been in hospital to have a baby, a Smear test seemed to be so much more violating. I know that might sound crazy, but my birth with Leo was so straightforward and simple, with very little to no medical intervention. I was checked once when I arrived into hospital, and it was discovered that I was already 9.5CM dilated, and after that I was shown to my birthing pool, and they just let me float around telling me 'if you feel like you need to push, then push'. And that my friends, really was it. I didn't need stitches or any follow ups, so I walked away with a beautiful baby, and a rather fantastic birth experience!

What prompted me to book my Smear Test in all of those years later, was the fact that I had been experiencing some unusual bleeding over the course of a few months. I guess you could say I just had a gut feeling, and with that feeling firmly in place, I called up my local surgery and they got me booked in back in December 2016.

The appointment took place the very next day and by Christmas Eve I had recieved my results letter. The letter confirmed an abnormal Smear Test result, it said that I had borderline changes and HPV (Human Papilloma Virus) that can cause abnormal tissue growth and cause cervical changes, which can sometimes lead to cervical cancer.

Girls aged 12-13 are offered a vaccination against HPV to help protect them against types of HPV that can cause cervical cancer. Women aged 25-64 are offered cervical screening to check for abnormal cells in the cervix, and as the vaccinations against HPV were introduced in more recent years, I fall into the category of having the screenings to check for the virus. 

Changes in the cells of the cervix are often caused by the human papilloma virus, and there are more than 100 different types of HPV to keep things interesting! Some types are high risk and some types are low risk. 

The cell sample that is taken during a cervical screening will be tested to see if there are any abnormalities. If a screening test shows low-grade or borderline cell abnormalities, the sample is then usually automatically tested for HPV. 

Test results can vary from:

- Normal - This means no abnormal cells have been found and you won't need to be seen until your next Smear Test (usually every 3 years).

- Inadequate - You may have to repeat the test as the sample initially taken could not be read properly. This could be because not enough cells were taken.

- Abnormal - If you have an abnormal Smear Test Result you could be told that you have: 

- Borderline or low-grade changes (called dyskaryosis) - If your result is low grade, it means that although there is change going on and some abnormal cell changes, they are very close to being normal and they may disappear on their own without treatment. 

- Moderate or severe (high-grade) dyskaryosis - If your result is high grade dyskaryosis, then your sample won't be tested for HPV and you will be automatically offered a colposcopy (where they have a closer look at your cervix and the cell changes that are going on). 

CIN (Cervical Intra-epithelial Neoplasia)

Sometimes the results will come back talking about CIN, but as with all official letters, these things can be very confusing and if you're like me, you will have to take to Google to find out what it all means. I spent a lot of time researching what the result terminology meant before I got my letter back, so I will break it all down for you below (as chances are you have landed here, if you are going through something similar).

CIN is divided into different grades, this describes how far the abnormal cells have gone into the surface layer of the cervix. The cell changes can be classed as CIN1, 2 or 3. 

This classification indicates how much of the cervix has been affected by abnormal cells. Essentially  the higher the number, the more of the cervix has been affected, and the more likely it is that treatment will be needed to remove the cells. 

CIN1 – This means that there are mild changes; affecting only one-third of the thickness of the surface layer of the cervix. These changes are not cancer, and in most cases do not progress into cancer in the future. Usually these cell changes will most likely go back to normal without treatment, but a repeat Smear Test is needed to check that the cells have gone usually within 12 months. 

CIN2 – Indicates moderate changes; affecting two-thirds of the thickness of the surface layer of the cervix. This is a little bit of a grey area, because they do not want to over treat you if you do not need it. They might want to see you again in a few months time for a Colposcopy to see if the changes are retreating or becoming more apparent. 

CIN3 – Indicates more severe changes, although this is not to be confused for cancer; It means that the cells are affecting the full thickness of the surface layer of the cervix, and this is where treatment will be essential. 

Colposcopy

As HPV was found in my sample along with borderline changes, I was referred to the clinical investigations unit at my local hospital for a Colposcopy. 

A Colposcopy is where they take a closer look at your cervix, so they can get a better idea of what is going on. The procedure does sound daunting but I have to say that it wasn't a bad experience at all. 

I was taken into a room to discuss my case with the lady who was going to be conducting my colposcopy, and she was amazing. She took the time to walk me through what was going to happen, and answer all of my questions. I was then lead into another room where there were two nurses, who would assist with the procedure. 

I was offered a wrap around to help preserve some of my modesty through the appointment, and then I lay down on a bed with my legs on rests so that they could get to business. There is a television screen that shows your cervix (hey my cervix has now been on TV!) and I got to watch the entire procedure, which was rather amazing in all honesty. 

They put some lotions and potions on the cervix so that the abnormal cells are highlighted. I could see white patches on the top and bottom of my cervix. The colposcopist told me that she thought that the bottom changes were nothing to worry about, but she thought that the top changes which were a little more substantial could be CIN 2 or CIN 3.

I recorded the entire audio of my appointment, so if you are due to go for one and are worrying about the procedure... Give this a watch and I guarantee that your mind will relax, The ladies made me feel immediately at ease, we made jokes and it was over in no time at all.

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Biopsies were taken and sent away to be tested. Within a few weeks I had a letter back from the hospital with very good news. The cervical changes that had been found were CIN1, this meant that I didn't need any treatment at all at this stage, and I now need to wait for a second Colposcopy letter, which will be for January 2018. Hopefully at this appointment the cells will have reverted to normal, if they haven't then I may require treatment.

For now though my mind is at ease and I am really impressed with just how amazing this whole experience has been. 

If you are due a Smear Test, or you have been putting it off like I did, please, please, please go and book it. It could save your life.