Few letters cause as much immediate worry as one containing the word “abnormal”. If your cervical screening result has come back showing high-risk HPV, abnormal cells, or both, the first thought is often the most frightening one.
We want to address that directly. An abnormal cervical screening result is not a diagnosis of cancer. In the overwhelming majority of cases it is not close to one. It is an early warning system doing precisely what it was designed to do, which is to find changes years before they could ever become a problem.
This article explains what each type of cervical screening result means, what terms such as dyskaryosis, CIN 1, CIN 2 and CIN 3 refer to, and what happens at each stage of the pathway.
In summary
Cervical screening in England tests first for high-risk human papillomavirus (HPV). If high-risk HPV is found, the same sample is then checked for changes to the cells of the cervix. An abnormal result means cell changes have been found, not that cancer has been found. NHS England reports that around 4 in 100 people screened have high-risk HPV together with abnormal cell changes, and that most people who go on to have a colposcopy do not have cervical cancer.
What cervical screening actually looks for
Cervical screening, previously called a smear test, does not look for cancer. It looks for the conditions that could allow cancer to develop many years later.
Nearly all cervical cancers are caused by infection with certain high-risk types of HPV, a very common group of viruses. According to NHS England, most people acquire some type of HPV during their lives and the body usually clears it without any intervention. A positive result is not a reflection of your sexual history, and it does not mean a partner has been unfaithful. You can carry HPV for many years without symptoms, and without having had a new partner.
In England, the NHS routinely invites women aged 25 to 64 for cervical screening every five years. Trans men and non-binary people with a cervix are also eligible, although how the invitation is issued depends on how gender is recorded in the GP record.
The five-year interval for those aged 25 to 49 is recent. NHS England moved this group from three-yearly to five-yearly screening on 1 July 2025, for people who test HPV negative, following a recommendation from the UK National Screening Committee. The change was not applied retrospectively, so if you were screened before that date you will still be invited at the interval you were given at the time.
Samples are tested for high-risk HPV first. Only if high-risk HPV is found does the laboratory then examine the cells for changes. That order matters, because if no high-risk HPV is present, cell changes are very unlikely to pose a risk.
The three possible results, explained
| Result | What it means | What happens next | How common |
|---|---|---|---|
| HPV negative | No high-risk HPV found in your sample | Routine screening again in 5 years. The sample is not checked for cell changes. Some people are invited sooner depending on previous test results | Around 87 in 100 |
| HPV positive, no abnormal cells | High-risk HPV found, but the cells themselves look normal | Screening again in 1 year, and 1 year after that if HPV persists. Colposcopy if high-risk HPV is still present after 2 years | Around 9 in 100 |
| HPV positive with abnormal cells | High-risk HPV found alongside changes to the cells of the cervix | Referral for a colposcopy to examine the cervix more closely | Around 4 in 100 |
Figures published by NHS England (GOV.UK, updated March 2026). Applies to England.
There is a fourth outcome. Sometimes the laboratory cannot obtain a clear result from a sample. This is usually described as an inadequate or unclear result, and it does not indicate that anything is wrong. You will be invited for a repeat test in three months.
What “abnormal cells” and “dyskaryosis” mean
If your result letter mentions dyskaryosis, this is the clinical term for changes in the appearance of the cells taken from your cervix. Cancer Research UK is explicit on this point: these changes are not cancer.
What they represent is cells that have been altered by a persistent HPV infection. Left unmonitored over many years, a small proportion of these changes could progress. Identified early, they are straightforward to monitor or to treat, which is the entire purpose of the screening programme.
Your result letter will explain your particular result in more detail. If cell changes have been found, the letter will also explain that you are being referred for a colposcopy, which is a closer look at the cervix rather than a treatment.
What CIN 1, CIN 2 and CIN 3 mean
CIN is a separate grading, and an important distinction to understand. It is applied after a colposcopy biopsy rather than to the original screening sample. CIN stands for cervical intraepithelial neoplasia, the term used for abnormal cell changes confirmed in cervical tissue. You may also see CGIN (cervical glandular intraepithelial neoplasia), which refers to changes in the glandular cells of the cervix.
| Grade | Category | What usually happens |
|---|---|---|
| CIN 1 | Low grade | Often no treatment is needed. Cancer Research UK notes these changes frequently resolve on their own once the immune system clears the HPV, which happens in most people. Repeat screening is usually offered in 12 months |
| CIN 2 | High grade | Treatment to remove the abnormal cells is usually offered, which lowers the risk of cervical cancer developing |
| CIN 3 | High grade | Treatment to remove the abnormal cells is usually offered, which lowers the risk of cervical cancer developing |
Grading and management per Cancer Research UK.
It is worth stating plainly, because the numbering suggests otherwise: CIN 3 is not cancer. It describes pre-cancerous cell changes, and it is treatable.
What happens at a colposcopy
A colposcopy is a closer examination of the cervix using a magnifying instrument called a colposcope, which stays outside the body. It is similar to having a screening test, and a small tissue sample (biopsy) may be taken at the same time. You can read more about what a colposcopy involves in our Health Information section.
If treatment is required, Cancer Research UK identifies LLETZ (large loop excision of the transformation zone) as the most common treatment for abnormal cervical cells. It is an outpatient procedure, usually carried out under local anaesthetic. A cone biopsy of the cervix may be recommended where abnormal tissue sits higher in the cervical canal.
One point that NHS guidance makes, and that is worth holding on to while you wait: any changes to your cells will not get worse during the time between your referral and your colposcopy appointment.
Symptoms that should not wait for a screening invitation
Cervical screening is designed for people without symptoms. If you have symptoms, do not wait for your next invitation. NHS England lists the following as symptoms that should be checked:
- Unusual vaginal bleeding for you, including bleeding between periods, after sex, or after the menopause
- Heavier periods than is normal for you
- Changes to vaginal discharge
- Pain during sex
- Pain in the lower back, between the hip bones (pelvis), or in the lower abdomen
NHS England notes that these symptoms are very common and can have many causes. That is reassuring, but it is not a reason to leave them unchecked. They warrant proper assessment rather than watchful waiting.
Why specialist assessment matters
A screening result letter is necessarily brief, and it rarely answers the question actually on your mind. Understanding what your particular result means for you, rather than what it means in general, usually requires a conversation.
General Practitioners play a vital role in the screening programme and in onward referral. What a specialist clinic adds is speed and continuity. At our Gynaecology Clinic, colposcopy is performed by a consultant gynaecologist, findings and next steps are discussed with you in the same setting, and you have a single point of contact throughout. For broader concerns, our Women’s Health Clinic offers assessment across the full range of gynaecological conditions.
