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What are the symptoms?
Precancerous cervical cell changes usually have no symptoms. The only way to know if there are abnormal cells in the cervix that may develop into cancer is to have a cervical screening test. If symptoms occur, they usually include:
- vaginal bleeding between periods, after menopause, or during or after sexual intercourse
- pelvic pain
- pain during sexual intercourse
- a change to your usual vaginal discharge, e.g. there may be more discharge or it may have a strong or unusual smell or colour
- heavier periods or periods that last longer than usual.
Any of these symptoms can happen for other reasons, but it is best to rule out cervical cancer. See your general practitioner (GP) if you are worried or the symptoms are ongoing. This is important for anyone with a cervix, whether straight, lesbian, gay, bisexual, transgender or intersex, even if you are up to date with cervical screening tests.
What are precancerous cervical cell changes?
Sometimes the squamous cells and glandular cells in the cervix start to change. They no longer appear normal when they are viewed under a microscope.
These early cervical cell changes may be precancerous. This means there is an area of abnormal tissue (a lesion) that is not cancer, but may lead to cancer.
Some women with precancerous changes of the cervix will develop cervical cancer, so it is important to investigate any changes.
How precancerous cell changes start
Precancerous cervical cell changes are caused by some types of the human papillomavirus (HPV).
HPV and cervical cell changes don’t cause symptoms but can be found during a routine cervical screening test).
Types of cervical cell changes
Abnormal squamous cells – These are called squamous intraepithelial lesions (SIL). They can be classified as either low grade (LSIL) or high grade (HSIL).
SIL used to be called cervical intraepithelial neoplasia (CIN), which was graded according to how deep the abnormal cells were within the surface of the cervix:
- LSIL, previously graded as CIN 1, usually disappear without treatment.
- HSIL, previously graded as CIN 2 or 3, are precancerous. High-grade abnormalities have the potential to develop into early cervical cancer over 10–15 years if they are not found and treated.
Abnormal glandular cells – These can be either low grade or high grade. High grade changes are called adenocarcinoma in situ (AIS or ACIS). They will need treatment to reduce the chance they develop into adenocarcinoma.
Treating cervical cell changes
Finding and treating precancerous cervical cell changes will prevent them developing into cervical cancer.
Which health professionals will I see?
Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist, such as a gynaecologist or gynaecological oncologist. The specialist will arrange further tests.
If cervical cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you will see a range of health professionals who specialise in different aspects of your care.
|gynaecologist||specialises in diseases of the female reproductive system; may diagnose cervical cancer and then refer you to a gynaecological oncologist|
|gynaecological oncologist||diagnoses and performs surgery for cancers of the female reproductive system (gynaecological cancers), such as cervical cancer|
|radiation oncologist||treats cancer by prescribing and overseeing a course of radiation therapy|
|medical oncologist||treats cancer with drug therapies such as chemotherapy and targeted therapy|
|radiologist||analyses x-rays and scans; an interventional radiologist may also perform a biopsy under ultrasound or CT guidance, and deliver some treatments|
|cancer care coordinator||coordinates your care, liaises with MDT members, and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)|
|nurse||administers drugs and provides care, information and support throughout treatment|
|nurse practitioner||works in an advanced nursing role; may prescribe some medicines, perform some tests and refer you to other health professionals|
|dietitian||recommends an eating plan to follow during treatment and recovery|
|social worker, psychologist||link you to support services; help with emotional and practical problems associated with cancer and treatment|
|women’s health physiotherapist||treats physical problems associated with treatment for gynaecological cancers, such as bladder and bowel issues, sexual issues and pelvic pain|
This information is reviewed by
This information was last reviewed in September 2021 by the following expert content reviewers: Dr Pearly Khaw, Lead Radiation Oncologist, Gynae-Tumour Stream, Peter MacCallum Cancer Centre, VIC; Dr Deborah Neesham, Gynaecological Oncologist, The Royal Women’s Hospital and Frances Perry House, VIC; Kate Barber, 13 11 20 Consultant, VIC; Dr Alison Davis, Medical Oncologist, Canberra Hospital, ACT; Krystle Drewitt, Consumer; Shannon Philp, Nurse Practitioner, Gynaecological Oncology, Chris O’Brien Lifehouse and The University of Sydney Susan Wakil School of Nursing and Midwifery, NSW; Dr Robyn Sayer, Gynaecological Oncologist Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Megan Smith, Senior Research Fellow, Cancer Council NSW; Melissa Whalen, Consumer.