Moderate cell changes and biopsy


I had my first smear test mid-December. I was told all looked clear and that I could expect a letter in 2-3 weeks with results, and that if HPV was found it would probably be a case of more regular smears.

I hadn’t had any post yet, but Jan 12th I had a missed call and then an automated text telling me my colposcopy was booked for 3 days later on the 15th. Thankfully managed to get a call back from the nurse who explained that I had high risk HPV and moderate abnormal cell change from the smear. She said that the unit had a bit of a backlog of tests to do which is why I was booked in for the colposcopy on Sunday (I’d have thought that meant I had longer to wait!).

At the colposcopy they talked me through the process and asked questions, and during the colposcopy they decided to do a biopsy as they’d spotted a patch of cell changes. From my understanding if they spot the cell changes then they’d usually go ahead with LLETZ or some other treatment then and there, so I’m a bit confused as to why they’d just biopsy. Are the possibilities that they’re checking then between that it’s CIN1/2 and they’d rather monitor, it is CIN 2/3 and treatment will be needed later, or something more?

Hi @R2023

They dont always remove the cells there and then, both of my colposcopies i had biopsies taken first before knowing whether id be monitored or treated as my smears didnt match the colposcopy, smears dont diagnose the abnormalities they just describe how different the cells look from normal ones so they are mostly an indicator that cells dont look right rather than an indicator that theres a precancer going on they then need to be diagnosed at a colposcopy… these changes arnt always caused by the HPV as the cells on cervix harmlessly change on a regular basis if they mix with our normal vaginal flora they can look abnormal, so a biopsy is needed to confirm that the area is actually a precancer and determine the actual grade of it…

The only way to grade them accurately is by taking a biopsy then they deciding if treatment or monitoring is necessary… mostly the opinion does match what they think it is, thats how they can do the “see and treat” method, but grading the abnormalities by eye like they do on smears and colposcopies they are just guessing, its an educated guess based off what they have seen before, but they arnt always correct cells can look worse or less than what they actually are, so this runs the risk of performing a LLETZ when there is no need, some do want that confirmation before offering a LLETZ

Its highly likely the smear doesnt match what was seen so they just want to make sure before deciding the next steps xx

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If you HPV high risk and then low changes like you said above they r not always caused by HPV however if you HPV is that the most likely cause.

Hi @Patty

Not necassarily, it can still be caused by other things like yeast, vaginal bacteria, douching, soaps etc but it could be the HPV itself making the cervix inflammed just not causing us a precancer

Borderline and low grade changes are mainly referred for a closer look so they can determine if what was seen on the smear is caused by the active HPV (precancer) or something clinically insignificant like inflammation as inflammation wont lead to a precancer even if it is caused by the active HPV… HPV effecting cells in this way arnt classed as clinically significant or classed as a precancer, they just need to identify these changes for what they are so they can monitor us more efficiently

When changes are found in our squamous cells, smears can come in many ways:

  • Borderline change: this means the cells still look kinda normal but not quite, usually its inflammation making the cells look a little different or it could be the start of cells beginning to change, but borderline changes arnt classed as a CIN/precancer
  • low grade dyskaryosis: inflammation could still be the cause, but the cells could also be at CIN1, these changes although a CIN arnt generally a cause for concern its not seen as a true precancer unless it perisists or progresses to a higher grade, most often than not it goes away on its own… they usually monitor this change with a follow up smear rather than treating it
  • high grade moderate dyskaryosis: they expect to see CIN2, it has more chance of progressing to a higher grade but there are still many cases of regression, they are more inclined to treat these changes but people can still opt for monitoring
  • severe dyskaryosis: CIN3 is expected from this result, this is the direct precurser and seen as the true precancer as this grade has less chance than the other two (there are still many cases who have regressed) so its treated ASAP as if it does progress the next stage would be CC
  • some have had a severe (?invasion) result - this means they expect CIN3 but they are also looking for an invasion as the smear has indicated malignancy could also be present


Thank you once again most likely have another question 2 moro :smile:

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I knew i would have another question
Its probably already been asked or i have read it and not taken it in.

Can you still have the HPV virus after they laser the cell changes.
In other words if you have treatment because of cell changes does that rid the body of the HPV as well or just the cell changes

lol yes it is possible to still test positive after the treatment not even a hysterectomy removes the virus, the treatments mainly target the cell changes the only thing known to control the virus is our own immune systems… but many women do test negative after having a LLETZ (me included) so its thought in most cases it can trigger the immune system to recognize the infection that was once evading it xx

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Thank you sorry for all the questions xx

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no need to apologise lovely, your more than welcome to ask any questions you like :slight_smile: xx

Colposcopy today

Smear test showed grade changes.
Consultant said the cervix looks fine and nothing there looks abnormal.
They did say they only thing was the cervix looked like it did because of the HPV.
They said they will see in a years time.
The cells were more than likely because of the HPV as there was no medium to high grade changes.
I just wanted to let everybody else know that just because you get a recall for colopscopy does not mean its the worst case scenario.
It can just simply be the HPV or even inflammation causing cell changes.
So all be strong
You all got this.
Love to you all.
Especially those who have always replied toy relentless posts.

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