Abnormal smears: wait and see

Subjecting women with mildly abnormal cervical smear test results to an immediate colposcopy examination is no more effective than simple observation (The Lancet, 10 July 1993).

Researchers in Leeds concluded that 1.6 out of every 1000 women with an initial ‘mildly dyskaryotic smear’ will go on to develop cancer if a ‘conservative repeat smear policy is adopted’, with cervical screening every three years. A policy of immediate referral for colposcopy – where the cervix is examined using a binocular instrument called a colposcope and often accompanied by a biopsy – is also associated with a subsequent cancer rate of 1.6 per 1000.

‘Therefore, repeating the smear is almost as effective as an immediate referral to a colposcopy unit,’ they concluded. ‘Even if a five-yearly cervical screening programme is adopted, 2500 women with a mildly dyskaryotic smear will need to be referred for immediate colposcopy to save one additional cancer.’

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Written by What Doctors Don't Tell You

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