Confusing results from cervical smear test

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Hi, just wondering if anyone has experience of this. My daughter had an abnormal smear result last year, high grade moderate dyskaryosis. She had a colposcopy and the result came back mild dyskaryosis. They had an MDT meeting because of the discrepancy and decided it was mild bordering on normal and to do nothing but repeat the smear in 12 months. She has just had the result, high grade, severe dyskaryosis. How can it go from high grade moderate to mild and then back to high grade severe? Have they missed it? 

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  • Posted

    How old is your daughter? Smear testing doesn't help women up to age 30, but women under 30 produce the most false positives, and those under 25 - 1 in 3 smears will be abnormal - this is the smear picking up normal changes in the maturing cervix or transient and harmless infections.

    We know lots of things can produce an abnormal smear - inflammation from tampons, condoms etc., infections, trauma, hormonal changes etc.

    I've heard of young women producing CIN 2 and then a normal smear 6 months later...

    In the past, most of these young women had "treatments" on their cervix, some left with damage that lead to health, psych and/or obstetric issues. Thankfully, some countries are finally making changes to offer some protection to young women.

    The Finns and Dutch have never tested before age 30, they have great results without the awful levels of over-treatment of CIN.

    The best program in the world, IMO, is the Dutch program, 5 HPV tests or HPV self-testing at ages 30,35,40,50 and 60 and only the roughly 5% who test HPV+ will be offered a 5 yearly smear (until they clear the virus or require treatment) This will save more lives and just as importantly, protects the vast majority of women who can never benefit from this testing.

     

  • Posted

    At 19 I had CIN 3 consistently which after multiple treatments ended up being removed via surgery. 

    Fast forward 20 years. 18 months ago - abnormal smear - severe. Colposcopy with a LLETZ treatment to remove it. 6 months later normal colposcopy but HPV+ high risk. Discharged back to my GP for another smear in 6 months, then assuming normal back to yearly the. 3 yearly. Smear done in Feb. Week later called to say severe - to be seen urgently. Colposcopy (again - yawn) Dr could only see CIN 1 at neck of cervix but couldn’t look at full cervix due to major scarring of the cervix. Said smears are highly reliable and the CIN 3 is higher up. Next stop - hysterectomy. Turns out my medication (for crohns) has caused the issue. Gastro has haulted all further treatment until I’ve had the hysterectomy. My Gynaecologist is all for doing the hysterectomy but head gynaecologist thinks it’ll be “better” to do colposcopies & LLETZ’s every 6 months (erm noooo!) So the battle is ongoing, meanwhile I’ve had no treatment for this latest bout of CIN 3 so fingers cross it’s not spreading as apparently with certain medications it can mestasie rapidly! So I’d say yes, it’s definitely possible for it to bounce up & down.. Definitely keep an eye on it.. 

    • Posted

      Hollaka...I'm really sorry hearing what you're going through. Are they testing your smears for HPV as well? As if your HPV NEGATIVE your extremely unlikely to go on and develop cervical cancer. As you say lots of things can produce abnormal results. ..even bathing or changing brand of tampons. Even severe cell changes can revert to normal without treatment. Every year 200,000 smears come back abnormal but obviously nowhere near that number go on to cancer. Recently research has found a lot of women are over treated...hope you recover soon x

    • Posted

      Hi there. Thank you for your reply, sorry it took so long to reply back, been a bit manic of late. Yes I’ve tested positive for HPV and they can’t get rid of that (not even sure if it’s something you can get rid of?) I had cin 3 as a teenager which resulted in surgery after multiple treatments which couldn’t remove the cells as they just kept regenerating rapidly (was on azathiaprine at the time but back then there wasn’t any link between the two like there is now). Then 20 years later & back on all these lovely medications it all comes back again. The smear showed cin 3 but the colposcopy couldn’t see far enough into my cervix due to all the scarring of previous treatments. I’m seeing the Dr on the 25th to asses for hysterectomy & now my other consultants are saying it’s highly unlikely I’ll go back on the medication anyway cos of this reaction I’ve had yet again. Fun fun fun 🙄

    • Posted

      Hollaka,

      You would fall into a different category, sadly, Crohn's and the medication you take to control it, the immunosuppressants, put you at higher risk of cervical dysplasia and cancer (the latter assuming you're HPV+) I note one research paper said it's similar to the increased risk if you have HIV.

      So sorry you're going through all of this, it sounds a nightmare, I'd say the important thing is to have confidence in your doctors and to get a second opinion if you need reassurance you're making the right treatment decisions. All the best...

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