No one wants to hear their smear test result has picked up abnormalities – but early detection and appropriate treatment can and does save lives by preventing cervical cancer from developing.
The latest report by the charity Jo’s Cervical Cancer Trust, ‘Not so simple,’ highlights the confusion and anxiety many women feel after receiving a diagnosis of cervical cell changes, and calls for greater consistency in the information and treatment pathways these women receive.
This is particularly the case when it comes to women diagnosed with CIN2 cell changes – a grey area in which there are discrepancies in the approaches used by doctors, according to Jo’s Cervical Cancer Trust.
CIN2 – where treatment could go either way
Cervical screening (or smear) tests detect cervical abnormalities – changes to the cells on your cervix. If you receive an abnormal result, this will be looked at in more detail during a procedure known as a colposcopy, where a doctor looks at your cervix under a microscope.
Cell changes on the outer surface of the cervix are then diagnosed as either high or low grade cervical intraepithelial neoplasia (CIN), depending on how deep the cell changes go. CIN1 is classed as low grade, and does not require treatment, but will be monitored to make sure the cell changes go away by themselves.
CIN3 is classed as high grade, and women will always be offered treatment (most commonly a LLETZ procedure – large loop excision of the transformation zone – or cone biopsy) to prevent these cell changes developing into cervical cancer.
CIN2 is also considered high grade, but the treatment pathways could go either way – women will either be treated to remove the cell changes, or they will be monitored every six months. “What we know anecdotally, from the women we speak with, it that it really varies depending on where you are in the country, which hospital you go to, or even down to which colposcopist you have,” explains Imogen Pinnell, Health Information Manager at Jo’s Cervical Cancer Trust.