Abnormal CST / Colposcopy / Cervical biopsy / LLETZ
The aim of a cervical screening test (CST) is to check whether high-risk human papilloma virus ( HPV) is present in a woman’s cervix. Cervical screening tests are important because they can help to prevent cervical cancer caused by high-risk HPV. The CST has replaced the PAP smear as the best test to screen women.
In every 100 cases of cervical cancer, about 95 are related to HPV infection. Although many women have had an HPV vaccine, they still need to have regular CST checks because the vaccine does not protect against all types of cancer that cause HPV.
High-risk HPV infection may cause abnormal changes in the cervical cells. This is called cervical dysplasia. Dysplasia is not cancer, but severe dysplasia can develop into cancer over a long and unpredictable time if left untreated.
If you have an Abnormal CST result you may be referred to see a gynaecologist for colposcopy. A colposcope is a magnifying instrument used to look at the cervix through the vaginal speculum to examine the cervix. The cervix is painted with acetic acid ( similar to vinegar) which causes abnormal cells to turn white. If abnormal cells are detected, a cervical biopsy is taken to send a small sample of the cervix to a pathology lab for diagnosis. If the biopsy shows a high grade cervical abnormality such as Cervical Intraepithelial Neoplasia ( CIN2, CIN3) then it is recommended that the abnormal cells are removed.
Removal of abnormal cervical cells can be performed in the rooms using local anaesthetic or as a day stay procedure in hospital under general anaesthetic. A Large Loop Excision of the Transformation Zone ( LLETZ) is performed where a semicircle wire loop is used to remove the portion of the cervix that contains the abnormal cells. Often this is all that is required to return the cervix to normal, however ongoing followup is required to ensure that no abnormality persists.