Case study: Cervical abnormalities

I read with interest your articles about cervical cancer in young women. My 18 year old daughter, after months of pains in her abdomen, went to a special clinic and had a smear test, which showed cell changes in her cervix.

She was then given a colposcopy, which caused such agony the day after that she screamed for a half hour in the car. The result of this showed a "precancerous inflammation in the cervix" and she was told to return for another test six months later. She has changed her way of life and eating to a more healthy one, though she still smokes.I am anxious about the next test and wonder if it will do more harm than good. I am personally inclined to trust in her own healing powers. S H, Pontefract, West Yorkshire.....

All abnormalities of the cervix are classified as "precancerous" often without justification; the question is what stage of abnormality she's been classified as. There are four categories of abnormal lesions, or cervical interstitial neoplasia: CIN I, II, III and cancer. What doctors still don't know is whether abnormalities in the CIN I and II categories will eventually progress to cancer. Given that, plus continual evidence of a wide disparity in interpretation of findings on smear tests (witness the recent mistakes in Britain affecting some 1000 smear tests), ask her doctor if you can follow more recent recommendations, to do repeat smears in six months or so to see if the abnormalities settle down. Make sure to have the smear tests done by an extremely experienced, reputable private laboratory to minimize chances of error and don't be afraid to ask what their error rate is. Remember too, the most important early warning sign of cervical cancer is bleeding between periods, say after sex, or persistent vaginal discharge. Also, while your daughter is making lifestyle changes, convince her that she has overlooked the most important one. Smoking is one of the major risk factors for cervical cancer.