Our knowledge of the triggers for precancerous cells of the cervix has grown massively in the last 15 years. We now know that some strains of the common wart virus (HPV) on the cervix can trigger abnormalities in cells. There is a vaccine available in Australia which protects an individual against HPV. Since the introduction of HPV vaccination, there has been a significant decline in the number of women having abnormal pap tests. However, there are a large number of women who have not had the HPV vaccination. All women need to be followed by the cervical cancer screening programme to make sure they do not develop cervical cancer. This is less likely to occur if they have been vaccinated against HPV, though it is still necessary to be screened. If abnormal cells are picked up on a pap test, and are persistent, the woman in question may require colposcopy.
Colposcopy consists of an examination of the cervix using a powerful microscope and harmless staining techniques which help decide whether a biopsy is necessary. A biopsy means the sampling of a tiny amount of tissue to send to the lab for further examination. We can offer colposcopy as a simple outpatient procedure in our Chatswood (Sydney lower north shore) clinic. If you feel very anxious about having a colposcopy, but need to have one, we can provide sedation in our dedicated procedural suite, to make it more manageable. This means a very brief, light anaesthetic, enabling you to be comfortable and relaxed during the procedure. For sedation, 2 doctors will be present, and a nurse, looking after you in our procedural suite.
If the biopsy ( taken at colposcopy) confirms precancerous change in the cells of the cervix, then you may need a loop excision ( Lletz procedure). This can be undertaken privately or publicly (if you have Medicare card). We can refer you to the relevant specialist in Sydney to undertake a loop excision if required. Loop excision is usually curative for the abnormal cells, as they are removed. This halts the progression of abnormal change in the cervix, though close follow up for the first 2 years after loop excision is required to ensure that the pap test remains within normal limits.