Colposcopy: What you need to know - HE1202

Taku hauora, taku tinana, taku tūmanako

My health, my body, my future

Kia ora and welcome

This information is for people referred to colposcopy (kol-poss-kapee). Usually this is because of an abnormal cervical screening test, but it could also be because your health provider recommends your cervix is checked.

The results of your cervical screening test have been sent to your health provider. Your nearest clinic has sent you a letter to arrange a colposcopy appointment.

What is a colposcopy

Colposcopy at a public hospital is free if you are eligible to receive public health care in New Zealand.

During a colposcopy a specialist uses a microscope to check the cells in your cervix.

Colposcopy is safe and effective.

It is important to attend your colposcopy appointment even if you don’t have any symptoms.

What causes abnormal cells

Human papillomavirus (HPV) is the main cause of abnormal cell changes and cervical cancer. You can find more information about HPV at the end of this pamphlet and also in the pamphlet Cervical Screening: Understanding Cervical Screening Results, code HE4598 on www.healthed.govt.nz.

Early treatment of abnormal cervical cells has about a 95 percent success rate in stopping these cells developing into cervical cancer.

Before your appointment

Your appointment may take up to an hour, however the actual colposcopy only takes about 15 minutes.

You are welcome to bring someone to support you such as your partner, a family or whānau member or a friend.

• If you have any questions about your appointment, please contact the clinic and ask to speak to a nurse, or you may want to talk to your health provider.
• If you have to change the time of your appointment for any reason, for example, if you think you might have your period on the day of your appointment, please phone the clinic as soon as possible.
• If you need an interpreter, please let the clinic know.
• Please tell the clinic if you are pregnant. It is safe to have a colposcopy when you are pregnant. However, it is unlikely a biopsy or treatment will be recommended during pregnancy. 

Ma te mōhio ka ora
Knowledge improves health and well-being

During your colposcopy

A specialist doctor or nurse carries out the examination and a nurse will also be there to help you. If you have any questions, ask the nurse or specialist.

You will be asked to lie on a bed with your legs placed in leg rests. A microscope will be put near your vagina. It will not touch your body. Just like when you had a cervical screening test, the specialist will put a speculum into your vagina. This makes it possible to see your cervix through the microscope.

The specialist brushes liquid onto your cervix, to show up any abnormal cells. For some women this may sting a little. Some small tissue samples may be taken of cells that look abnormal. This is called taking a biopsy. When the tissue sample (a biopsy) is taken, you may feel a quick, sharp pinch.

After your colposcopy

At the clinic, the specialist will talk to you about what they saw during your colposcopy.

For a few days after your colposcopy you may have some pain, similar to period pain. Rest and do what you usually do when you have period pain.

If you had a biopsy, you may also bleed a little or have some reddish discharge from your vagina. This is normal and should stop within a week.

Until the bleeding stops and your cervix is healed, please:

• use sanitary pads, not tampons
• have showers instead of baths
• do not use spa pools and swimming pools
• do not have sex.

If you start to bleed more than when you have your period, or if the bleeding goes on for more than a week, please phone the clinic for advice.

Getting your results

Your biopsy sample is sent to a laboratory to find out exactly what sort of changes are happening in your cervix. It takes up to four weeks for the clinic to get your biopsy results. The clinic may post your results to you or phone you. If you have not received a letter or phone call after four weeks, please phone the clinic.

Your results will also be sent to the National Cervical Screening Programme as well as your health provider.

The results of a biopsy may show there is nothing wrong with the cells in your cervix or there is something abnormal in the cells. Sometimes you may need another colposcopy if your biopsy results are not clear.

There are four main types of abnormal cell results:

1. Mild changes, also known as low-grade changes
2. Moderate to severe changes, also known as high-grade changes
3. Glandular cell changes or adenocarcinoma-in-situ
4. Changes suggestive of cervical cancer.

You should be reassured that most cell changes are not cancer but it is important that changes are treated early to prevent cancer developing.

Treatment

The specialist will tell you if your abnormal cells need to be treated. Sometimes a follow-up cervical screening test or colposcopy is recommended instead of treatment.

The type of treatment you need will depend on:

• the type of cells
• where they are on your cervix
• the size of the abnormal area.

The specialist will discuss the treatment options with you.

Cervical cancer and HPV

• Almost all cervical cancer is caused by HPV. HPV is spread by sexual activity and affects almost all people at some point in their lives. 
• There are many types of HPV. Most HPV infections will clear up by themselves.
• Only a few types of HPV will lead to abnormal cells that could progress to cancer.
• Cervical cancer usually takes many years to develop. Abnormal cells can be found and treated to stop them from becoming cancer.
• Testing for HPV may be offered following a colposcopy in some special circumstances. This test and the results can be discussed with your doctor.

The National Cervical Screening Programme

The aim of the National Cervical Screening Programme is to reduce the number of people who develop cervical cancer.

When you have a cervical screening test you are enrolled in the Programme unless you choose not to be. You can withdraw from the Programme at any time by filling in a form or by writing to the Programme. You can re-join the Programme at any time.

What information is collected or used?

The information collected by the programme is stored on a computer system called the NCSP Register which is managed by the Ministry of Health. De-identified laboratory specimens or results may be used for quality or teaching purposes.

The Clinical Guidelines for Cervical Screening in New Zealand 2020 provide information for health professionals on the management of abnormal cervical screening results. The guidelines can be found at www.nsu.govt.nz.

For further information about enrolment in the National Cervical Screening Programme, call 0800 729 729.

Further information

If you have questions about your appointment or the information in this pamphlet:

• contact the colposcopy clinic or your health provider
• contact the National Cervical Screening Programme on 0800 729 729
• visit our website at www.timetoscreen.nz
• visit the health education website at www.healthed.govt.nz.

For more information contact the National Screening Unit, the Ministry of Health, on (04) 496 2000.

If you change your address, please advise your smear taker, and the National Cervical Screening Programme, on freephone 0800 729 729 or email info@ncspregister.health.nz.

Code: HE1202