Dr Richard Murphy

Colposcopy

If your GP or your gynaecologist recommends a colposcopy, then this means the cervix and vagina will be carefully examined under a microscope looking for signs of precancerous disease. This is a standard procedure very similar to having a Pap smear (now called a Cervical Screening Test). Being referred for a colposcopy can cause a lot of stress; just remember we are looking for precancerous changes, where early intervention can prevent more serious disease.

Obstetrics and gynaecology consultations at my private practice in Subiaco.
Fertility consultations at Fertility Specialists of Western Australia in Applecross
Delivering at the Labour Ward of SJOG Subiaco Hospital

What is a colposcopy?

A colposcope is a microscope used to examine the cervix and vagina. The aim is to detect any pre-cancerous or abnormal cells, allowing treatment before more serious disease occurs. The procedure is very quick. It takes about ten to fifteen minutes and is done in my rooms.

If a high-grade area is seen at colposcopy then you will need a biopsy. In that case, a small tissue sample is taken to be examined by a specialist pathologist.

"Almost all cancers of the cervix, as well as cancers of the vagina, labia, anus and throat, are associated with certain strains of the human papillomavirus, the “high-risk HPV” strains. If you have no high-risk HPV on your Cervical Screening Test (CST) then the test can safely be repeated in 5 years."

Dr Richard Murphy, Perth gynaecologist

In the past, it was recommended that most women routinely had a Pap smear every two years. Since December 2017, the traditional Pap smear was replaced by the Cervical Screening Test to screen for precancerous changes on the cervix. This change reflects advances in medical knowledge over the last 10 years or so.

It is easy to contract HPV through person to person contact. Four out of five people*, both men and women, will have a HPV infection at some point in their lives. In most cases they won’t know about it.

* https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Patient%20information/Cervical-Screening-in-Australia-Pamphlet-261017.pdf?ext=.pdf

“If you smoke or have a compromised immune system you are less likely to clear the HPV and hence have a persistent infection.”

Dr Richard MurphyGynaecologist Perth
colposcopy perth

HPV vaccination to prevent cervical cancer

Since 2007 all Australian girls have been offered vaccination for the 2 highest risk strains of HPV, types 16 and 18. Boys have subsequently been vaccinated also, starting in 2013. The number of strains covered in vaccinations has increased over time, with the Gardasil-9 vaccine covering nine types of HPV since being introduced in 2018.

"If your CST detects high-risk HPV the specimen will be automatically screened for cytological abnormalities or changes in the appearance of cells on your cervix. Depending on the combination of HPV and cytological abnormality you have your GP may recommend a colposcopy."

Dr Richard Murphy, Gynaecologist Perth

Do I have cancer when I need a colposcopy?

Almost certainly not! Colposcopy allows us to detect precancerous, as well as cancerous changes. Detecting cancer at colposcopy is, thankfully, very rare.
Of course, as a gynaecologist, I understand that getting these test results back can be stressful. Particularly if we have to tell you that you have a ‘high-risk HPV’ or if we have found ‘cytological changes’ on your cervical screening test.

"The good news is that once we know it is there, we can manage and treat you properly, looking after your long term health and avoiding cancer. Remember, HPV associated disease progresses slowly, over a number of years, so the only real danger is not having regular testing."

Dr Richard Murphy, Gynaecologist Perth

If I am concerned there may be a high-grade lesion on your cervix, then a biopsy will be taken to confirm the diagnosis before definitive treatment. You will get your results after 1-2 weeks. If the biopsy shows a high grade pre-cancerous lesion then surgical treatment will be recommended.

Large Loop Excision of the Transformation Zone (LLETZ) is the most common treatment for high grade changes of the cervix. Occasionally a Cone biopsy surgery may be needed instead. When planning your surgery we will discuss your plans for future fertility. The goal of this ‘bigger-picture’ conversation is to reduce the risks of preterm birth and cervical stenosis.

"Colposcopy and biopsy happen as an outpatient, in my rooms. Following a biopsy or colposcopy, a small amount of bleeding can occur. You should avoid tampons, intercourse or other activities which may exacerbate this until the bleeding or spotting has settled"

Dr Richard MurphyPerth gynaecologist