Gynaecology Specialist Perth
Dr Roger Perkins
Dr Roger Perkins | Gynaecologist in Perth
Abnormal cervical screening test (pap smear test)
In December 2017, Australia moved to a national program of cervical screening, now called the Cervical Screening Test. All women are recommended to have the test every 5 years, commencing at age 25. This test looks for the presence of Human Papilloma Virus in the sample, and if present, this is followed by a secondary test looking at the features of the cervical cells under a microscope (cytology). This replaces the previous test which was called the Pap Smear.
Nearly all cervical cancers are caused by the HPV virus. Hence, cervical screening for HPV will detect at risk women many years before they develop any cancerous changes.
These are some of the reported results your gynaecologist may want to discuss with you:
HPV results:
- HPV 16/18 detected
- Oncogenic HPV (not 16/18) detected
- Oncogenic HPV not detected
Further evaluation of the same sample looking for cellular abnormality is undertaken if HPV is detected.
The cytology results and conclusions may be:
- Negative
- Possible low grade squamous
- Low grade squamous
- Possible high grade squamous
- High grade squamous
- Squamous cell carcinoma
- Atypical glandular cells
- Possible high grade glandular
- Adenocarcinoma in situ
- Adenocarcinoma
Dr Roger Perkins | Colposcopy Perth
Why do I need a colposcopy?
Your gynaecologist will recommend a colposcopy in case of inflammation, infection, precancerous or cancerous changes in the cells of your cervix. A biopsy or other diagnostic procedures may be needed if you have any of these symptoms.
If HPV is detected, close follow-up is advised, which involves seeing a gynaecologist with special training in the management of cervical disorders.
I am a specialist gynaecologist in Perth certified with the Australian Society for Colposcopy and Cervical Pathology for the diagnosis and treatment of cervical pathology.
Dr Roger Perkins | Perth Gynaecologist
Colposcopy procedure
A colposcopy is performed by your gynaecologist, using a special magnifying instrument called a colposcope. This instrument will make early changes more visible, with the aim of doing a directed biopsy. This involves removing a very small selected piece of tissue in order to be examined under a microscope by a pathologist. The colposcopist is trained to detect certain features such as alteration in blood vessel patterns and changes in colour which will direct the biopsy site. The pathology report will check to see if the cells are becoming precancerous. Sometimes other features are detected, such as inflammation or infection. The final report usually takes several days to get a result.
The biopsy along with features seen on colposcopy will then determine whether the cells should be removed.
Colposcopy may also be indicated for other reasons, such as abnormal spotting or an unusual appearance of the cervix.
The procedure is performed in a calm, private room and does not require an anaesthetic. It is usually painless and only takes around 5 minutes. You are very welcome to bring a support person with you.
Dr Roger Perkins | Colposcopy Perth
What happens after the colposcopy?
Dr Roger Perkins | Gynaecologist Perth
Risks associated with a colposcopy
The histopathology is the report that summarises the results of your colposcopy and it will be reported as one of the following:
- No abnormality
- Low-grade squamous lesion
- High-grade squamous lesion (CIN 2 or CIN 3)
- Squamous cell carcinoma
- Adenocarcinoma in situ
- Adenocarcinoma
Low-grade changes are usually followed up by observation and testing in 12 months.
If high-grade abnormal cells are detected at the colposcopy, then a LLETZ procedure is the usual recommendation. This is performed in a day surgery unit using anaesthesia so that it is painless. The abnormal cells are removed and sent for further histopathology checks. You will go home the same morning. You are free to return to work the next day. Expect some discharge and spotting for a couple of weeks. You should avoid strenuous activity for 3 weeks, and avoid intercourse until the area has healed, usually 6 weeks. Occasionally, heavier loss occurs and this may require antibiotics and cauterisation of the LLETZ site. Laser treatment of the cervix is rarely done any more. Cone biopsy, which is a different procedure to the LLETZ, is occasionally required to remove especially deep lesions. There are no significant long-term effects of the LLETZ procedure on your fertility and no significant increased problems in pregnancy.
More about Dr Roger Perkins
Heavy Periods
About Dr Roger Perkins
"My aim is to make you feel comfortable at all times. My consultation style is unrushed and I respect your schedule by minimising waiting times. You are a unique person and I make it my goal to truly get to know you."
