- HPV+ with normal cytology is usually just monitored yearly.
- HPV+ with abnormal cells means colposcopy, not automatically treatment.
- Delay is the enemy — bring the pathway forward if the wait is long.
The NHS pathway in plain English
If your smear is HPV positive with no abnormal cells (normal cytology), you are usually invited back in 12 months to see whether the infection has cleared. Two negative annual results and you return to routine screening every 3–5 years.
If your smear is HPV positive with abnormal cells (any grade of dyskaryosis), you are referred for colposcopy — a magnified examination of the cervix — usually within a few weeks.
What colposcopy involves
Colposcopy takes 10–15 minutes and is done in outpatient. A speculum is placed exactly like a smear; the cervix is painted with dilute acetic acid, which makes abnormal areas turn white. If a suspicious area is seen, a small biopsy is taken. Most women describe the sensation as pinch-like, not painful.
You get the biopsy result within two to three weeks. Findings are graded as CIN 1 (mild), CIN 2 (moderate) or CIN 3 (severe). CIN 1 often regresses on its own; CIN 2 and CIN 3 usually need treatment.
If NHS waiting times are long
In parts of the UK the wait from an abnormal smear to colposcopy is now several months, and further follow-up is often stretched. Many women in London, Manchester, Birmingham and Edinburgh choose to bring the timeline forward by having a consultant-led colposcopy privately — either in the UK or, at a lower cost, in Istanbul.
Frequently asked questions
How long can I safely wait for colposcopy?
For high-grade abnormalities, ideally within 2–4 weeks. Low-grade changes are less urgent but should not be left over 6 months.
Does colposcopy always mean treatment?
No. Around half of women referred to colposcopy have either normal findings or CIN 1 that only needs surveillance.
Can I have colposcopy on my period?
It is best to schedule it outside heavy bleeding — the view is clearer and any biopsy is easier to interpret.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your test results and giving you a clear, personalised next step.
Request a video consultation