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  • Q&A with Australian Health Practitioners

    Will I need treatment for a "high grade lesion"?

    Related Topics
    Cancer Cervical Cancer
    My Pap smear came back with possible high grade lesion does that mean I will def need more treatment after colposcopy?
    • 2 answers
    • Australian Cervical Cancer Foundation
    • Dr Shian Miller
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    Australian Cervical Cancer Foundation

    ACCF’s Vision is to protect and enhance women’s health by eliminating cervical cancer and enabling treatment for women with cervical cancer and related health issues, … View Profile

    Dr Gino Pecoraro, Advisory Panellist for the Australian Cervical Cancer Foundation has the following response: “High grade lesions are the most significant of the changes seen in a Pap test. I would recommend that you need to be referred to a gynaecologist who will arrange for a colposcopy and biopsy of any lesion seen. Treatment after that depends on the exact diagnosis, but will maybe require some form of surgery but it is best to get all of this clarified with your specialist.”

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    Dr Shian Miller

    Gynaecologist, Obstetrician

    Dr Shian Miller is a Brisbane Obstetrician Gynaecologist who has rooms on Wickham Tce in Brisbane city and admitting rights at Greenslopes Private Hospital. She … View Profile

    Hi,

    The simple answer is "No" - you will not "definitely" need treatment, only "potentially".

    When a pap smear comes back as "high grade" or "possible high grade" the recommendation is to see a gynaecologist for a colposcopy.

    It is possible that at colposcopy, it will be confirmed high grade, in which case treatment will be recommended. One of the exceptions would be if you are under 25 years old and the biopsy comes back as only CIN2, in which case repeating a colposcopy in 6 months rather than treatment may be an option.

    It is possible that at colposcopy, the changes may be only low-grade. The reason it was called "high grade" on the pap smear could be due to inflammation, infection, or any number of factors. It is also possible that during the time interval where you had the pap smear and the time you then had a colposcopy, the changes had become low-grade. If the cervical changes are thought to be only low-grade on colposcopy then a repeat pap smear in 12 months is usually reasonable.

    Management depends on many factors and the best thing to do is get an individualised plan from your gynaecologist.

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