Cervical screening: the colposcopy examination

When women receive an abnormal test result they may be asked to attend for a colposcopy examination for further investigation.

Colposcopy is a simple examination that allows the doctor to see the type and area of the abnormality on your cervix. It also helps the doctor decide if you need treatment. (NHS Cancer Screening Programme – The Colposcopy Examination 2012)

The examination is similar to a cervical screening test, but it involves a more detailed look at the cervix. A magnifying device, called a colposcope, is used to examine the cervix and to see the area of abnormal cells more clearly. The colposcope does not go in to your body.

A small sample of the abnormal cells (a biopsy about the size of a pinhead) may also be taken during the examination to assess the stage of the abnormal cells.

The colposcopy and biopsy will enable doctors to assess whether the cell changes are Cervical Intra-epithelial Neoplasia (CIN). CIN means abnormal cells found on the surface of the cervix. The cell changes are classed as CIN1, CIN2 or CIN3. This classification is used to indicate how far from the surface of the cervix the abnormality extends.Treatment is usually given to remove CIN2 or CIN3 abnormal cells. It is done in the outpatient colposcopy clinic, sometimes the same time as the examination.

We talked to women about their experiences of the colposcopy examination.

Some of the women we interviewed had had several colposcopy examinations over a number of years without needing treatment. Others had treatment performed at their colposcopy examination (see other topics in ‘Treatment and side effects‘).

Describes her experience of the colposcopy examination.

Age at interview 63

Gender Female

Age at diagnosis 50

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Describes her experience of her colposcopy examination and biopsy.

Age at interview 48

Gender Female

Age at diagnosis 48

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Describes her experience of the colposcopy and biopsy.

Age at interview 42

Gender Female

Age at diagnosis 25

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Kim describes her experience of colposcopy.

Age at interview 34

Gender Female

Age at diagnosis 33

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During the colposcopy examination, women sit on a special type of chair which has padded supports where they can rest their legs. The chair is then tilted backwards. Several women we talked to felt embarrassed that they had to undress and have their legs on the padded supports, but many found the nurses and doctor put them at ease and explained what they were doing at each stage of the procedure. Many women said the examination was not as bad as they had imagined, others said it was worse than they expected.

The colposcopy examination was much better than Laura had expected.

Age at interview 39

Gender Female

Age at diagnosis 37

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The colposcopy examination and biopsy was different to what she expected and she felt traumatised.

Age at interview 35

Gender Female

Age at diagnosis 34

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Solutions of iodine and acetic acid are applied to the cervix, which are used to highlight the abnormal cells on the cervix. Some women said they felt a stinging sensation, others said they did not feel anything when these liquids were applied.

She did not feel any discomfort when the iodine solution was put on her cervix.

Age at interview 27

Gender Female

Age at diagnosis 20

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At some colposcopy clinics, women can choose to view the examination on a TV screen. This was reassuring for some women and enabled them to take their mind off the procedure. Others chose not to look at the screen. One woman found it upsetting.

Some women did find it painful to have a biopsy taken; others experienced only a little discomfort or none at all.

Having a biopsy taken was painful.

Age at interview 30

Gender Female

Age at diagnosis 21

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She did not feel any discomfort or pain when her biopsy was taken.

Age at interview 54

Gender Female

Age at diagnosis 54

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A spray is sometimes used to numb the area before taking the biopsy and some women found this painful or uncomfortable. After the biopsy several women said they had some bleeding for a short while and a few experienced cramps. This is normal and women advised others to take sanitary towels to the appointment.

After their appointment several women felt emotional, others felt relieved and positive. A few women mentioned that it was helpful to have someone accompany them to their appointment.

She felt drained physically and emotionally for a few hours after her colposcopy examination.

Age at interview 30

Gender Female

Age at diagnosis 21

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Explains that she felt very emotional after her first colposcopy examination.

Age at interview 35

Gender Female

Age at diagnosis 28

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At the colposcopy examination, ‘The doctor may be able to tell you what is wrong and what treatment, if any, is needed. But often, especially if you have had a biopsy, you will not be given a definite diagnosis immediately after the examination. It will take a week or two before you get the results of the biopsy”. (NHS Cancer Screening Programme – The Colposcopy Examination 2012).

For more information on CIN see our section ‘Cervical abnormalities: CIN3 and CGIN‘.