Suspected cervical cancer
Your gynaecologist has informed you about an abnormal Pap smear result or you are HPV positive? Or possibly both? Suddenly you are at risk of getting cervical cancer. You start to reconsider. Together with your gynaecologist, you now have to find the method of clarification that suits you best.
Good news first: although cervical cancer is caused by human papillomavirus (HPV) infection, only few infections actually develop into cervical cancer. In Germany, about 200,000 women are diagnosed with a suspicious Pap smear every year, but only few are serious.
Cervical cancer and its precancerous stages
A precancerous stage can be present if the surface cells of the cervix are degenerated, but have not yet proliferated into deeper cell groups. These changes do not yet cause any symptoms. These changes are also called dysplasias. Dysplasia is not yet cervical cancer, but may develop over years.
Cervical cancer only causes symptoms in an advanced stage. Discharge, intercourse bleeding, postcoital bleeding, or unexplained weight loss may indicate a serious disease.
If abnormal cellular changes or precancerous stages have been detected in a woman, a conisation will be the next step. A conisation is also performed if a colposcopy-guided biopsy could not provide a clear diagnosis. When performing a conisation, the opening of the cervix into the vagina is cut out in a conical shape.
However, conisation is associated with considerable risks. Changes in the shape and width of the cervix or birthing cervix are possible, as is scarring. Conisations increase the risk of premature birth or miscarriage in later pregnancies. In rare cases, conised women have difficulty falling pregnant.
Watchful Waiting describes the strategy of monitoring the course of the disease. An HPV infection can heal on its own with no consequences. Slight cellular changes at the cervix can also be reduced. Doctor and patient have time to monitor a cervical disease as it develops over years. Of course, this strategy depends on the severity of the cellular changes.
The watchful waiting strategy is psychologically very stressful for many women. However, at regular intervals, affected women have to go for check-ups fearing their results may have changed for the worse.
This page is intended to give patients a summary overview of the topic. Reading this page does not replace a medical consultation or a discussion with your doctor.