In Hong Kong, cervical cancer is the seventh most common cancer among females and accounts for roughly 3.3% of all new cancer cases for women since 2016. Besides practising safer sex and getting the HPV (Human Papilloma Virus) vaccination, the best option in lowering your risk of developing cervical cancer is by attending regular cervical screenings.
Although many women already schedule regular Pap smears, there is another form of screening that you should be aware of: colposcopy. To fully educate our patients about the benefits of cervical screenings, our blog walks you through everything you need to know about cervical screenings, and in particular, colposcopy. So hopefully at your next appointment (or even your first!), you can be armed with greater knowledge.
Why should you get regular cervical screenings?
Regular screenings are vital in protecting yourself from any cancer. Finding any concerning cell changes early on can mean better monitoring and access to effective treatment, giving the problematic cells a smaller chance to turn into cancer, such as cervical cancer. Regular screenings are especially important for cervical cancer, as symptoms are less apparent early on. In fact, symptoms may not be present at all until cancer has reached an advanced stage.
Who needs cervical cancer screening?
The Hong Kong Department of Health’s Cervical Screening Programme (CSP) recommends that women aged between 25-64 should go for a screening every three years.
At a minimum, sexually active women should start having smears done from 25 years old onwards
OT&P Obstetrician Dr Zara Chan
You should also get regular cervical screenings if you’re:
- A healthy woman who has no symptoms;
- A woman who no longer has their period; hasn’t had sex for many years; or has had sterilisation;
- A woman who has received HPV vaccination in the past (you still need screenings as the vaccination does not protect against all HPV types);
- A woman aged below 25 years old who has had sex (or been exposed to other risk factors such as multiple sex partners, smoking or weakened immunity).
If you’re unsure whether or not you should receive a cervical screening, you should seek the advice of your doctor.
What is a colposcopy?
Since 2004, the HK CSP has recorded 92.9% of smear results as negative for ‘intraepithelial lesions’ or ‘malignancy’ while 6.3% of results were abnormal. Your doctor may refer you for a colposcopy because of abnormal smear results, genital warts, persistent vulval or vaginal discomfort, or if they repeatedly fail to obtain an adequate smear sample from the cervix so that they can further diagnose any problems.
A colposcopy is a diagnostic procedure where the cervix (opening of the womb), vagina and vulva are examined in detail with special solutions and a microscope. This view is greatly enlarged and allows the doctor to examine the cervix in detail.
A colposcopy will be able to inform the doctor (and you) whether the abnormal smear result is due to HPV infection, or cellular abnormality such as CIN (cervical intraepithelial neoplasia).
How is a colposcopy different than a Pap smear?
A colposcopy is a lot like getting a Pap smear, the main difference being the tools used to perform the examination. A Pap smear involves your doctor collecting cells from your cervix using a brush or spatula, but in a colposcopy, your doctor will use a special magnifying instrument called a colposcope. Both screenings usually take around 10–15 minutes to perform.
What you can expect during your colposcopy
The colposcopy is performed by an experienced doctor and is a day procedure. In some cases, it can be done by a family doctor who is familiar with gynaecological check-ups.
Once the magnifying instrument, or colposcope, provides a clear view of your cervix, your doctor will look through the lens to identify any abnormalities. They may apply a special solution to the area, as it helps to highlight any suspicious cells. The solution can sometimes be slightly uncomfortable and cause a burning or tingling sensation.
If suspicious cells are identified, your doctor will want to take a sample of the tissue (a ‘biopsy’) to send for further examination at a laboratory to confirm what they see. If your doctor does not identify any suspicious cells, the results of your colposcopy can usually be relayed to you during your appointment. If you’ve had a biopsy, your doctor will let you know when your results can be expected.
After your colposcopy, you can usually return home straight away and resume your normal activities, but some women prefer to take a rest until the next day. If you’ve had a biopsy, you may have temporary vaginal discharge or light bleeding. This will be normal and should stop within a few days. You should also wait until the bleeding stops before having sex, using a tampon or any lubricants and creams. Speak to your doctor if you’re in doubt.
What if my colposcopy results show an abnormality?
For some women, the smear and colposcopy results may show a more severe abnormality, and your doctor may want to perform a LEEP (Loop Electrosurgical Excision Procedure).
What is a LEEP?
A LEEP is a type of treatment that prevents cervical cancer by removing abnormal cells from your cervix. It involves using a small electrical wire loop to remove the cells and is usually done in a hospital to reduce the risk of infection.
You may feel some discomfort during your LEEP; however, most women don’t feel much as your doctor will apply numbing medicine to the area. After the procedure, some women opt to stay overnight, but the surgery can also be done during the day.
Although the abnormal cells are removed, it is important to continue doing smears afterwards to detect any future changes!
OT&P Obstetrician Dr Zara Chan
How can OT&P help?
In short, a colposcopy can be described as just a very in-depth gynaecological check. And although getting an abnormal result can be worrying, it is essential for you to continue undergoing cervical screenings. It cannot be stressed enough that regular screenings are instrumental in catching cervical cancer early so that it can be treated promptly.
If you’re looking to have a cervical screening or for more advice about cervical health in Hong Kong, at OT&P our obstetricians and gynaecologists are highly skilled and knowledgeable to help with any issues. Book an appointment or get in contact with us today.