Cervical abnormalities: follow-up care

Many of the women we interviewed talked about having follow-up care a few months after treatment. A colposcopy and cervical screening test (smear) are usually performed 4–6 months after treatment. Further follow-up may be advised once the results of colposcopy or / and cervical screening tests are received. Usually this involves regular cervical screening tests for a set time.

A doctor explains that follow-up care is individualised and depends on a number of factors,…

Gender Female

View profile

Most of the women we talked to were pleased to have follow-up care because they felt that, if abnormal cells were found again, they would be treated early. Many were unsure when their first follow-up appointment after treatment would be, how regular these appointments would be and what they would involve. Some were also unsure whether and for how many years they would be seen at a hospital or at their local surgery. Several women said they would have liked more information about follow-up care.

Joanne had a follow-up appointment six months after treatment. If the results were clear, she…

Age at interview 36

Gender Female

Age at diagnosis 35

View profile

Genevieve has annual cervical screening tests (smears) at her GPs surgery and regular…

Age at interview 41

Gender Female

Age at diagnosis 33

View profile

Many of the women we spoke to had their first follow-up appointment 6 months after treatment and the second 6 months later. They then had annual appointments for 10 years, which involved having a cervical screening test (smear). A few women had colposcopies at the hospital as well as cervical screening tests at their GP surgery.

Susan feels reassured by having annual follow-up. She went back to the hospital for her…

Age at interview 31

Gender Female

Age at diagnosis 25

View profile

Women often felt reassured that they were being monitored annually and said they would feel uneasy about being screened every three years on the NHS Cervical Screening Programme. Others, who’d had clear results for some time, were now back to 3-yearly screening.

Sarah now has three yearly cervical screening and always attends. She felt reassured by having…

Age at interview 35

Gender Female

Age at diagnosis 25

View profile

Ann Marie now has smear tests every three years. She sees her GP if she has any unusual symptoms,…

Age at interview 44

Gender Female

Age at diagnosis 29

View profile

Many of the women we talked to felt anxious before their follow-up appointments, especially the first one, in case further abnormalities were found. One woman was unsure whether she’d need more treatment at her first follow-up appointment. Sandra was told that her results were clear after treatment but, at her first follow-up appointment, she was disappointed to be told that she’d need more treatment.

Sandra was relieved when her results after treatment were clear. Later, when she was told there…

Age at interview 50

Gender Female

Age at diagnosis 48

View profile

Some of the women we interviewed said they were concerned about having a recurrence (see ‘Recurrence of abnormal cells‘). Michelle’s anxiety was exacerbated by media coverage of reality TV star Jade Goody’s experience of cervical cancer. Jane had been so anxious about having a recurrence that she missed two follow-up appointments in case abnormalities were found. Patricia worried so much about a recurrence before each follow up cervical screening test (smear) that she decided to have a hysterectomy.

Michelle had her first follow-up appointment after five months instead of six because she was…

Age at interview 31

Gender Female

Age at diagnosis 30

View profile

Jane worried about having a recurrence at a time in her life when she was very busy. She had four…

Age at interview 45

Gender Female

Age at diagnosis 35

View profile

Treatment for CIN is very effective and, in most cases, successful first time. A few women, though, did have a recurrence, which was found at follow-up. They were treated again, usually by LLETZ (see ‘Recurrence of abnormal cells‘).

Women still need follow up if they have had a hysterectomy for abnormal cells (see ‘Hysterectomy‘). The cervical screening test (smear) will be taken from the top of the vagina, near where the cervix was. This is called a ‘vault smear’. Very rarely, the abnormal cells can come back in this area, so women are offered cervical screening tests six months and one year after a hysterectomy. If everything is fine, no further cervical screening tests are needed.

Rachel had just had her first vault smear. She was anxious beforehand, and was waiting for her…

Age at interview 36

Gender Female

Age at diagnosis 35

View profile

HPV as a ‘test of cure’

The NHS Cervical Screening Programme is introducing an HPV ‘Test of Cure’ for women who have undergone treatment for cervical abnormalities (CIN 1, 2 or 3). When women return for follow up screening, 4 to 6 months after treatment, if the test shows normal, borderline or mild screening results, the sample will also be tested for HPV. If HPV is detected or the screening test shows an abnormality, women will be referred again to colposcopy. If the screening result is normal and the HPV result is negative, women will return to routine recall for cervical screening every 3 years. This new policy aims to reduce the need for up to 10 years of annual cervical screening.

Perceptions and experiences of healthcare

Many of the women we interviewed were happy with the care they received from doctors and nurses because they'd been informative, sensitive and approachable. Some...