Why Another Colposcopy?

Hi I’m new to this forum. I am 46 years old and for the past 3 years I have tested positive for HPV. Last year I had my first abnormal pap smear with atypical cells. I had a Colposcopy which came back normal. I just had another pap test and hpv was positive again and pap smear shows no change in atypical cells. The doctor office called me and told me that I could wait until next year and repeat the paper smear. But when I went into the dr for follow up she says I need another Colposcopy next week. I don’t understand why I need another Colposcopy if my last one was normal? Is it safe for me to refuse this Colposcopy and see what my pap smear and hpv says next year?

Hi @unvmeh247

Sorry I’m having abit of a blonde moment lol - has your recent pap showed there is still atypical cells? as in no change from the previous result but the colposcopy showed different so you think it could be the same again this time around?

When a pap shows atypical cells “ASCUS” it means atypical cells of undetermined significance, in other words they couldnt determine how abnormal they looked they just dont look like normal ones do… as cells change harmlessly on the cervix on a regular basis mixing with normal vaginal flora it can make them look abnormal, so they need a colposcopy to determine if the changes are caused by the active HPV and accurately grade the changes if there are any, smears dont diagnose our cells they just describe how different they look and indicate that we need further investigations…

If I’ve misunderstood and your pap was clear: as there has been x amount of positives for the virus in a row, it usually triggers the protocol for a colposcopy regardless if theres been one previously mainly just as a precautionary measure as abnormal cells can form inbetween, as great as our paps are they arnt always 100% so they are mainly just covering their own backs to make sure they havnt missed anything

Either one though, based off my own experience with cell changes my advice would be to have the colposcopy, you can never be too careful xx


Yes recent pap shows abnormal cells.

I don’t know exactly what the diagnosis is except that The HPV is high risk and the cells are abnormal. The first 2 years I tested pos for HPV my pap was normal. The past 2 years HPV still pos and pap showed abnormal cells. I don’t bleed regularly anymore because I have a an IUD. I do spot randomly when I would typically have a cycle and the blood is always black. I’ve been told that is normal with the liletta iud. I did bleed for about a week after my pap but it was light and still black. I ovulate every month and get cysts that are quite painful but otherwise I don’t have any symptoms. I figure if my colposcopy was normal last year then why wouldn’t it be normal this year too if nothing else got worse. I worry about unnecessary tests that make me uncomfortable.

When ASCUS is found its more important to go to these appointments as they cant determine what they are looking at, severe changes arnt ruled out with ASCUS and some have been diagnosed with it, its safer to know the grade so the right management can be offered, it could even be that last time between the smear and colposcopy the cells regressed and thats why nothing was seen but it doesnt mean it will be the same this time around

This whole thing is daunting with a few twists and turns along the way lol but in my experience it can go from 0-100 when you least expect… my first abnormal smear was 2020 HPV+ borderline change the colposcopy upgraded to CIN1 and i was on a 12 month recall, the follow up smear was HPV+ low grade dyskaryosis so i thought fab theyve stayed the same, when i went to the colposcopy however biopsies confirmed carcinoma in situ/CIN3 with a suspected invasion (luckily there was no CC just precancerous changes only) and i needed a LLETZ treatment… smears arnt always accurate xx

1 Like

Thank you Tinkerbelle for clarifying that for me. It makes sense to have the colposcopy when u explain it like that. I hope I shouldn’t be worried. Oddly I’m not worried at all. I think that normal colposcopy last year gave me a bit of security. From what I’ve read I can’t imagine anything harmful could have grown in one year… especially when I have no symptoms. I will have the colposcopy next week and keep u posted on the results. Thank you :grin:

1 Like