For many, a letter from the doctor can feel like it is written in another language. Words like ‘dyskaryosis’ or ‘neoplasia’ can be confusing and, frankly, quite frightening when you do not have a medical degree.
When that letter is about an abnormal smear test result, the anxiety can be overwhelming.
It is a moment when you need clear, simple answers, not a complicated medical textbook. In his London practice, Mr Saurabh Phadnis, a highly respected Consultant Gynaecologist and Oncological Surgeon, makes it his mission to cut through the jargon. He believes that every patient deserves to understand their health in plain English. An abnormal result is a conversation starter, not a final verdict. It is the beginning of a clear and manageable journey, and having a trusted expert to translate the medical-speak into real answers is the first and most important step toward peace of mind.
Let’s get the biggest fear out of the way first: an abnormal smear test result does not mean you have cancer. Think of your smear test as a very effective early warning system for your cervical health. An ‘abnormal’ finding simply means that this system has detected some changes in the cells on your cervix that are not quite standard. These are not cancerous cells. Instead, they are cells that have the potential to become problematic many years down the line if they are left completely ignored. The entire point of the screening programme is to find these changes at this very early, treatable stage. So, rather than a cause for panic, an abnormal result is a sign that the system is working perfectly, giving you and your doctor a valuable head start to ensure you stay healthy for the long term.
So, what causes these cell changes? In almost all cases, the culprit is an incredibly common virus called the Human Papillomavirus, or HPV. The best way to think about HPV is that it is like a common cold of sexual activity—most people will get it at some point in their lives, often without ever knowing. For the vast majority, the body’s own immune system will fight off the virus and clear it naturally, just as it would with any other bug. In a small number of people, however, the virus can linger and cause the cells of the cervix to change. Finding HPV in your sample is not a sign that you or your partner have been unfaithful, and it has no bearing on your ability to have children. It is just a very common virus that we need to keep an eye on.
When cell changes are found, they are graded to understand how significant they are. The lowest level of concern is described as ‘borderline’ or ‘mild’ changes. The official medical term is Cervical Intraepithelial Neoplasia grade 1, or CIN 1. This essentially means that only a very thin, surface layer of the cervix has slightly different cells. Because these changes are so minimal, the body is very likely to heal itself. The immune system will often kick the HPV virus out, and the cells will go back to normal all on their own. For this reason, the usual plan is not to rush into treatment. Instead, your doctor will simply keep a watchful eye, inviting you back for another smear test in a year to check that things are resolving as expected.
If the changes are more noticeable, they will be classified as ‘moderate’ (CIN 2) or ‘severe’ (CIN 3). This means that a thicker layer of the cervical lining is affected by the changed cells. It is crucial to understand that even at this stage, it is still not cancer. However, these are the types of cells that are more likely to become cancerous if they are left untreated for many years. Therefore, a result of CIN 2 or 3 is the point at which your doctor will recommend taking action. This is a preventative step. By treating these cells now, you are removing the risk of them ever turning into a more serious problem. This is the ultimate goal of screening: to stop cancer before it even has a chance to start.
After an abnormal smear result that requires a closer look, you will be invited for a colposcopy. This word might sound intimidating, but the procedure itself is very straightforward. It takes place in a clinic and feels a lot like having a smear test. You will be asked to lie down comfortably, and a speculum will be used to get a clear view of your cervix. The specialist then uses a colposcope, which is essentially a pair of binoculars on a stand with a bright light, to look at your cervix up close. It stays completely outside your body. To see the cells more clearly, a harmless liquid is dabbed onto the cervix, which makes any changed areas stand out. The whole thing is designed to be as simple and stress-free as possible, giving the expert a detailed view of what is going on.
During the colposcopy, the specialist might see a small patch of cells that they want to be absolutely sure about. To do this, they will take a biopsy. This involves taking a tiny sample of the tissue, often no bigger than the head of a pin. You might feel a brief, sharp pinch, but it is over in a second. This tiny sample is then sent to a lab to be examined under a microscope. This is the only way to be 100% certain about the grade of the cell changes (whether it is CIN 1, 2, or 3). The biopsy gives your doctor the final, clear picture they need to recommend the perfect plan for you, ensuring you get exactly the right care—no more and no less than what is needed to keep you healthy.
If it turns out you need treatment, the standard method is a simple and highly effective procedure called LLETZ. It is usually done right there in the clinic, often at the same time as a colposcopy. First, a local anaesthetic is used to completely numb your cervix, so you will not feel any pain. The specialist then uses a very thin wire loop that is gently heated by an electrical current to remove the small patch of changed cells. It is incredibly precise, like a very neat little trim, and the whole process is over in just a few minutes. This simple action removes the problem cells entirely, effectively preventing them from ever causing trouble in the future. It is a quick, safe, and definitive way to protect your long-term health.
After the treatment, you can get back to your normal life almost immediately. You might have some mild, period-like cramping or some light bleeding for a short while, but this settles down quickly. Your ability to have children is not affected. The most important part of the process comes six months later, when you will be invited for a follow-up smear test. This is to check that all the changed cells are gone and that your body has cleared the HPV virus. Once you get the all-clear from this test, you are back on track. Attending this follow-up is the final, crucial step in the journey, confirming the treatment was a success and giving you complete peace of mind to move forward.
Medical language can often build a wall between patients and a true understanding of their own health. Breaking down that wall is the key to feeling in control. An abnormal smear test is a perfect example: what sounds terrifying in medical jargon is, in reality, a straightforward and manageable health alert. It is your body’s early warning system working perfectly, giving you the time and opportunity to act. With a clear guide like Mr Saurabh Phadnis, the path from a confusing result to a clean bill of health is simple and reassuring.
If you are in the London area and want to discuss your smear test results without the confusing jargon, we warmly invite you to schedule a consultation with Mr Phadnis. Get the real, simple answers you deserve.
A smear test is a screening tool; it is like a quick look to see if there are any signs of change. A colposcopy is a closer inspection; it is like using a magnifying glass to get a really detailed view of the cells your smear test has flagged, to figure out exactly what is going on.
It is completely normal to feel a bit self-conscious, but the doctors and nurses who perform colposcopies do them every day. They are professionals who are focused on your health and will do everything they can to help you feel relaxed and preserve your dignity. Your comfort is their priority.
While HPV is passed through sexual contact, it is so common that it is not thought of in the same way as other sexually transmitted infections (STIs). Most people who have ever been sexually active will have it at some point. It is more of a fact of life than a specific medical condition to be worried about.
For the mildest, low-grade changes (CIN 1), waiting and monitoring is the standard approach because they often do go away. However, for more significant, high-grade changes (CIN 2 and 3), treatment is recommended because the risk of them progressing over many years is higher. Your doctor will advise the safest path for you.
The procedure is done using a local anaesthetic, which is an injection or cream that completely numbs the cervix. You should not feel any pain during the treatment itself, though you might feel some mild, period-like cramps afterwards. Most people find the experience much more comfortable than they expected.
