Colposcopy

A colposcopy is a procedure to find out whether there are abnormal cells on or in a woman's cervix or vagina. The cervix is the part of the womb that sits in the vagina.

Abnormalities tend to occur at the opening of the cervix to the birth canal, where it enters the womb. A colposcopy allows a doctor or trained nurse to find these abnormalities.

In some women, the presence of "abnormal cells" carries the risk of developing cervical cancer. A colposcopy is used to determine whether treatment will be needed to deal with these cells.

When a colposcopy is needed

You may need a colposcopy after having a routine cervical screening test. Other reasons for having a colposcopy may include:

• some of the cells in your cervical screening sample are abnormal (but not necessarily cancerous)
• you are infected with human papillomavirus (HPV), which is the main cause of the abnormal cell changes and might lead to cancer
• you've had several screening tests, but it wasn't possible to give you a result
• the nurse or doctor who carried out your screening test thought your cervix didn't look as healthy as it should

A colposcopy can also be used to investigate things such as unexplained vaginal bleeding (for example, after sex) or an inflamed cervix.

Read more about why a colposcopy is used.

What happens during a colposcopy?

The procedure is usually carried out in an outpatient hospital clinic by a specialist called a colposcopist. This can be a doctor or a specially trained nurse.

You'll be asked to lie down in a special type of chair with padded supports to rest your legs on. A device called a speculum will be inserted into your vagina and gently opened to allow the colposcopist to examine your cervix.

A microscope (colposcope) with a strong light will be used to look at your cervix. The colposcope doesn't enter the vagina and remains outside your body. If the colposcope has a camera attached to it, you may be able to see images of your cervix on a small screen. Some solutions will be applied to the cervix to highlight the abnormal areas.

If any abnormal areas are identified, a small sample of tissue (a biopsy) may be removed for closer examination. A biopsy is similar to a small pinch or scratch in terms of sensation, and shouldn’t be too painful. The purpose of a biopsy is to confirm whether your screening test has been correct in identifying a problem.

However, the colposcopist will sometimes be confident that the screening test has been correct without the need for a biopsy, and may decide to proceed immediately to treatment (see below).

The colposcopy procedure usually takes about five minutes, but it can take longer (10 to 15 minutes) if treatment is carried out. Overall, including the time it takes to discuss your problem with the colposcopist, your appointment should last 20 to 30 minutes.

A colposcopy can be slightly uncomfortable for some women. If you find it painful, you should tell the colposcopist, who will try to deal with your discomfort or stop the procedure entirely.

Read more about what happens during a colposcopy.

Colposcopy results

The colposcopist will usually be able to tell straight away if there are abnormal cells in your cervix. Biopsy results usually take about four weeks and a copy will be sent to both you and your GP in the post.

About 4 out of 10 women who have a colposcopy have a normal result. A normal result means your cervix appears healthy and you have a low risk of developing cervical cancer before your next screening test. Depending on your age, you'll be invited for a cervical screening appointment in three or five years.

About 6 out of 10 women who have a colposcopy have abnormal cells in their cervix. This doesn't mean they are cancerous cells, but they can sometimes develop into cancer if left untreated.

Very rarely, some women are found to have cervical cancer during a colposcopy. If you have cancer, you'll be quickly referred to a specialist team for care and treatment.

As cervical cancer detected through screening tends to be diagnosed at an early stage, the outcome of treatment tends to be better. This is why it's important for women to attend their screening test when invited.

Read more about colposcopy results.

Colposcopy treatment

Mild abnormalities don't always need to be treated. If treatment is needed, the aim is to remove the abnormal cervical cells while preserving as much normal tissue as possible.

The most common treatment is large loop excision of the transformation zone (LLETZ). The transformation zone is the area of tissue just at the entrance of the birth canal. LLETZ involves using a heated wire loop to remove the abnormal cells, and in the majority of cases is carried out using a local anaesthetic. The procedure lasts a few minutes and can be carried out during a colposcopy.

Removing abnormal cervical cells is usually successful (about a 90% success rate). You should be invited for a follow-up cervical screening test to check that the treatment has been successful. 

Read more about colposcopy treatments.

Try not to worry

If you're referred for a colposcopy after an abnormal cervical screening test, you shouldn't assume you have cervical cancer.

Less than 1 in 1,000 women referred for a colposcopy are found to have cervical cancer that requires immediate treatment.

Cervical cancer screening is successful because cell changes can occur many years before cancer can develop. Identifying and treating these cell changes at an early stage can prevent cancer from ever developing.