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Cell Changes

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

A smear test from your cervix can show whether you have cell changes. Cell changes are not the same as cancer but in rare cases it can develop into cancer, if it is not treated. If the cell changes are discovered in time, almost everyone can be treated and the woman fully recovers. Therefore, it is important to have a smear test performed with you general practitioner.

A smear test can show cell changes that must be followed up. The cause of cell changes is an infection with a certain virus (HPV). There is a vaccination against the virus available.

What can you do?

When you decide to have a smear test performed you must make an appointment with your general practitioner. The smear test cannot be performed while you have your menstruation. If you are pregnant, the smear test cannot be performed until after you have given birth.

What can your doctor do?

You doctor performs the smear test with a brush from your cervix during a gynaecological examination. It is not painful. The smear test is sent to microscopic examination and you will have a result during 1 to 3 weeks. Talk to your doctor about how you receive the answer. Maybe the doctor sends you a letter or an e-mail or perhaps the agreement is that you call for the answer. If the smear test shows that the cells are normal, you only need to think about repeating the smear test after about 3 years.

In some cases the test is unfit and must be redone. This may be the case if there is not enough cells in the sample, if there is too much blood or if you have an infection.

In some cases, the test shows cell changes and then you must be examined by a specialist. The specialist will be able to determine whether the cell changes require treatment or if it is a false alarm.

What can a specialist doctor do?

It is your general practitioner who refers you to a specialist in gynaecology. If there is suspicion of cell changes, supplementing examinations must be performed by a specialist in gynaecology. The gynaecologist performs a new gynaecological examination, looks for changes in the cervix with an endoscope and takes tissue samples (biopsies) from the cervix.

Some women think it is a little painful to have the tissue samples taken and it can cause pains similar to those associated with menstruation. The best thing to do is to relax as much as possible and not tense up since this worsens the discomfort. You can ask for local anaesthesia of the cervix.

It may bleed from the vagina the first few days after the biopsies. In some cases, the doctor puts some gaze into the vagina in connection with the biopsies. You remove the gaze yourself after 3 to 4 hours. You must take it easy the first 24 hours after the biopsies have been taken. The results from the biopsies are ready after some weeks. Remember to make an agreement with the doctor about how you receive the answer. Cell changes may be light, moderate, severe or show incipient cancerous changes.

Light cell changes: Light cell changes disappear by itself again during about a year. Light cell changes are very common with younger girls and are caused by a passing infection. Only 1 % of light cell changes can – untreated – lead to cancer. Therefore, light cell changes only need controls until they have disappeared. If the changes do not disappear by themselves a conic section may be the best solution.

Moderate cell changes: With 5%, moderate cell changes may develop into cancer if untreated. In the other cases the changes do not increase in time and some decrease by themselves. Since you do not know beforehand with whom the changes worsen, a conic section is recommended if moderate cell changes are found.

Severe cell changes and incipient cancerous changes: Severe cell changes only rarely disappear by themselves and with 10-20 %, cancer may develop if the changes are not removed. In the case of incipient cancerous changes, every other woman may develop cancer. Both in the case of severe cell changes and incipient cancerous changes a conic section is performed.