Gynaecology
Abnormal Cervical Screening & Colposcopy
An abnormal cervical screening result is not a diagnosis of cancer. For most women it simply means a closer look is needed — and in the vast majority of cases, changes either resolve on their own or are easily treated.
Cervical screening is designed to detect changes before they become a problem. Most abnormal results reflect low-grade changes that need monitoring rather than immediate treatment.
Australia's cervical screening program now tests primarily for HPV (human papillomavirus) — the virus responsible for almost all cases of cervical pre-cancer and cancer. An abnormal result may mean HPV was detected, that cervical cell changes were found, or both. The next steps depend on the specific findings and are clearly guided by national protocols.
What your result may mean
Cervical screening results fall into a number of categories, each with its own recommended pathway.
HPV not detected
A normal result. Routine rescreening in five years is recommended.
HPV detected, no cell changes
HPV is present but no cervical cell changes have been found. A repeat test in 12 months is usually recommended to see whether the infection has cleared.
Low-grade cell changes (LSIL)
Mild changes to cervical cells. These frequently resolve without treatment. Colposcopy is recommended to assess further.
High-grade cell changes (HSIL)
More significant changes that carry a higher risk of progression if left untreated. Colposcopy with biopsy is recommended promptly.
Possible high-grade or cancer
Results indicating possible cancer or very high-grade changes require urgent referral and colposcopy — these are uncommon but need prompt, expert assessment.
What colposcopy involves
Colposcopy is a detailed examination of the cervix using a magnifying instrument. It is performed in rooms and takes around 15–20 minutes.
You lie on an examination couch as you would for a pelvic examination. A speculum is gently inserted to visualise the cervix.
A colposcope — a magnifying instrument that remains outside the body — is used to examine the cervix in detail. It does not enter the vagina.
Dilute acetic acid (similar to vinegar) and iodine solution are applied to the cervix. These highlight abnormal areas as colour changes that would not otherwise be visible.
If an abnormal area is seen, a small tissue sample (biopsy) is taken. This causes a brief pinching or cramping sensation. Local anaesthetic is used for more extensive biopsies.
Biopsy results are usually available within two weeks. The results guide the next step — which may be surveillance, treatment, or discharge back to routine screening.
Understanding biopsy results
Cervical biopsies are graded by the degree of cellular change found in the tissue.
Treatment options
Treatment is tailored to the grade of change found, your age, and fertility plans. Not all abnormal results require treatment.
Surveillance
For low-grade changes, colposcopic surveillance with repeat testing at defined intervals — allowing time for the body to clear the changes naturally.
LLETZ (Large Loop Excision)
The most common treatment for CIN 2 and CIN 3. A thin wire loop removes the abnormal area of the cervix under local anaesthetic, usually as a day procedure.
Cone biopsy
A cone-shaped piece of cervical tissue is removed — used for glandular lesions, very high-grade changes, or when a larger specimen is required for accurate diagnosis.
Referral for further management
If invasive cancer is identified or suspected, prompt referral to a gynaecological oncologist is arranged without delay.
Clear information, calm expertise
An abnormal cervical screening result is one of the more anxiety-provoking letters a woman can receive. Dr Krones places particular emphasis on clear, unhurried explanation of what the result means, what the next steps involve, and what the realistic outlook is — so that the process feels manageable rather than frightening.
Colposcopy and cervical procedures are performed in rooms at North Shore Private Hospital. Results are communicated promptly and in full, and follow-up is coordinated according to national guidelines.
When to see a specialist
You should see a specialist if:
- Your GP has recommended colposcopy following a cervical screening result
- You have received an abnormal result and want a specialist explanation of your options
- You have had a previous LLETZ or cone biopsy and are due for specialist follow-up
- You have symptoms such as irregular bleeding, post-coital bleeding or unusual discharge requiring investigation
Book a consultation
Dr Krones consults at Suite 3A, North Shore Private Hospital, St Leonards, with operating privileges at North Shore Private Hospital and The Mater Hospital, Crows Nest.
A valid GP or specialist referral is required for all new appointments.
02 9053 1245