The reason women have pap smears is to detect pre-cancerous changes in the surface of the cervix so they can either be watched or treated depending on how far down the road to cancer they’ve gone.

The condition is called cervical intraepithelial neoplasia or CIN.

If CIN is graded at 2 or 3 then the abnormal tissue needs to be got rid of. The two techniques are ablation, which destroys the tissue or a cone biopsy, which cuts it out.

There is a problem with these techniques though because the cervix, being the neck of the womb, is critical in pregnancy, holding back the baby until it’s the right time for delivery.

A weakened cervix can put the woman at risk of a premature baby but some have argued that just having a human papilloma virus infection causing CIN is the problem, not the treatment.

A study bringing together all the available information on this has come up with answers that allow women with CIN to have a meaningful conversation with their doctor. It turns out to be true that CIN in its own right increase the risk of preterm delivery but treating CIN raises the risk even further.

So where does that leave women’s choices? Well CIN does have to removed or destroyed.

You don’t want to develop cervical cancer. It’s a nasty disease. There’s no difference between ablation and cone biopsy it’s important for the doctor to remove just enough tissue to do the job but not too little so they have to repeat the procedure which increases the risk yet more.

Last Reviewed: 28/08/2019

© Norman Swan Medical Communications.