Colposcopy is a test that can find abnormal cells on your cervix, vulva, and vagina.
During the exam, your doctor uses a magnifying device called a colposcope. This device allows your doctor to see problems that might be missed by the naked eye. If a problem is seen during the exam, your doctor may take a small piece of tissue (biopsy) from your cervix to take a closer look at the cells.
Colposcopy may be done after a Pap test shows that you have minor cell changes on your cervix. An abnormal Pap test means that the test found some cells on your cervix that don't look normal. It doesn't mean that you have cancer. In fact, the chances that you have cancer are very small.
All abnormal Pap tests require some kind of follow-up to be sure that the cell changes haven't become worse or have returned to normal.
If you have atypical squamous cells of undetermined significance (ASC-US) cell changes, there are several follow-up options you can choose from. Most of the time, ASC-US cell changes stay the same or return to normal on their own. ASC-US changes are not likely to develop into cervical cancer.
Your choices of what to do next include:
If you're pregnant and have ASC-US cell changes, your choices are the same as those for women who aren't pregnant.
Most of the time, colposcopy is not advised for women who have gone through menopause, because a natural decrease in estrogen levels is likely to cause minor cell changes.
Instead, a period of watchful waiting and repeat Pap tests are tried first.
Colposcopy is usually not painful, but it may cause some mild cramping. The tool (speculum) used to spread open your vagina is in place longer than during a routine pelvic exam. This may cause some discomfort.
A biopsy may be done at the time of colposcopy. You may feel a brief, sharp pain or have some cramping while this is done.
After the test you may:
Your doctor may recommend colposcopy if:
|Have colposcopy||Don't have colposcopy|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I was finishing school, starting a new job, and planning a wedding when the women's clinic called and said my Pap test was abnormal, with minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). She says I do not have any high-risk factors for cervical cancer and that waiting about 6 months to 12 months to follow up would be fine. I feel comfortable with her recommendation and have so much to do right now that watchful waiting feels okay."
— Indira, age 34
"I started worrying as soon as my doctor called and said my Pap test was abnormal. She said the results showed only minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). I could follow up with another Pap test in about 12 months. But I had just heard about a woman at my health club who was diagnosed with cervical cancer and is now undergoing treatment. With that fresh on my mind, I knew I couldn't wait to see if everything was okay. So I asked my doctor what else we could do. She said we could schedule a colposcopy examination as follow-up rather than waiting."
— April, age 29
"I had an abnormal Pap test in my early 20s. My doctor at the time explained that an abnormal Pap is common in young, sexually active women. My tests have all been normal now for several years. I recently changed jobs and moved, so I didn't have a routine exam for almost 2 years. Now I have another abnormal Pap test, and the results classify the cell changes as ASC-US (atypical squamous cells of undetermined significance). My new doctor explained that further testing for high-risk human papillomavirus (HPV) types may determine how serious these cell changes are and help me decide what to do next. Because of my past health, it sounded reasonable to find out more. The HPV test was negative, which made me feel better. Now I only need follow-up Pap tests to monitor the cell changes."
— Margaret, age 32
"I'm studying overseas for 3 months, so I had my regular gynecologic examination and Pap test at the student health clinic before I left. The results showed minor cervical cell changes called atypical squamous cells of undetermined significance (ASC-US). The health clinic nurse said that these changes are not usually treated and that follow-up Pap tests are usually all they recommend to monitor the minor cell changes. She reassured me that watchful waiting would be appropriate and told me to come back for a follow-up Pap test after I return home."
— Aisha, age 22
"My health professional just called with the results of my routine Pap test. I have some minor cervical cell changes classified as atypical squamous cells of undetermined significance (ASC-US). I've had sexually transmitted infections before, so I knew I might be at risk for an abnormal Pap test. He recommended that I have testing for the human papillomavirus (HPV) to determine if I have a high-risk HPV type. Further testing, such as repeat Pap tests or a colposcopy, will depend on the HPV test result. Since my husband and I want to start a family soon, it will be best to follow up now so we know what we're dealing with."
— Connie, age 32
"I had a Pap test and found out I have something called atypical squamous cells of undetermined significance (ASC-US). My doctor told me that I could wait and have another Pap test in a few months to see if I may need treatment or I could have a colposcopy. I'm getting ready to go back to college, and I don't want to worry that something might be wrong. So I've decided to have the colposcopy."
— Paola, age 21
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have colposcopy
Reasons not to have colposcopy
I'm worried that the abnormal cells may turn into cancer.
I want to wait and see if the abnormal cells return to normal on their own.
I'm not afraid to have a biopsy if my doctor sees a problem during the colposcopy.
I don't want to have a colposcopy or biopsy if I don't need to.
I'm not worried about how much colposcopy costs.
I don't have insurance, and I can't afford to pay for the test myself.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT having colposcopy
1. Do most minor cell changes go away on their own?
2. Is it okay to wait a while to see if the abnormal cells return to normal on their own?
3. Can HPV infection cause minor cell changes to get worse?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Kirtly Jones, MD - Obstetrics and Gynecology|