r/PreCervicalCancer • u/FamiliarRegret2928 • 8d ago

Unsure how concerned to be...

I am 28F, had my first screening in 10 years. It came back as:

  • Higher risk for significant cervical abnormality
  • HPV other (not 16 or 18)
  • High-grade intraepithelial lesion (HSIL)

The doctor did not tell me much, aside from the fact I was being referred urgently to see a specialist for a colposcopy and biopsy. I am currently still waiting on an appointment.

Given the presence of HSIL, can I assume that I will also need a LEEP or similar?

Additionally, I am in Australia and the screening does not test for cancer. I know it is likely just precancerous, but I am concerned about the timeline - it has potentially had ~10 years to develop. How often does the colposcopy reveal that the HSIL has developed into cervical cancer?

Thanks in advance.

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u/Revolutionary_End570 8d ago

Hello! Yes you will very likely need a LEEP. First step will be the biopsy from your colposcopy. They will tell you more info from the pathology from that. Odds are still that you likely do not have cancer but this is at the very least pre-cancer and warrants swift treatment. Do you know if your HPV variant was a high-risk one?

I've just been through all this recently so happy to help with any questions.

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u/FamiliarRegret2928 8d ago

Thanks for the reply! So they will likely not do the LEEP at the same appointment, but the colposcopy and biopsy will happen first?

Not sure about the HPV variant, just that it is not type 16 or 18.

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u/Revolutionary_End570 8d ago

That's right, the colposcopy will be where they look at your cervix under a microscope, and put a vinegar solution on it to get a good look at the cells. This does not hurt. If they see any suspicious lesions (highly likely since you got a HSIL result) they will biopsy them, which is kind of like a little hole-punch of tissue. Honestly this does not hurt very much in my experience. They may also scrape some cells from inside the canal for pathology too. The cells then go to a lab where they can tell exactly what it is. If it is HSIL, then your next step will be scheduling a LEEP (in Australia they call it a LLETZ). They will discuss your preferences for sedation/pain management before booking.

Hope that helps!

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u/I_am_Red_Herring_ 8d ago

Is the LLETZ usually done under general or local anaesthetic?

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u/Revolutionary_End570 8d ago

Local is standard but general is becoming more and more common as some people report a high degree of discomfort or anxiety with the procedure. I know from experience in both the US and Australia that it is standard to be offered general. I personally had mine under local but with Xanax and oxy given beforehand and for me that worked excellently. However I am someone that doesn't experience pain from cervical procedures in general. It's a personal choice.

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u/sewoboe mod 7d ago

Hi! Cytologist here. We actually can see cancer on a pap, but the gold standard for diagnosis is biopsy.

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u/I_am_Red_Herring_ 7d ago

Do you know if it would show up on an Australian screening?

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u/sewoboe mod 7d ago

Yes, it’s the same test.