Usually you begin by seeing your family doctor (GP) who will examine you and arrange for any tests that may be necessary. Your GP will refer you to hospital for the tests and for specialist gynaecological advice and treatment.

If abnormal cells are found in a smear test or liquid-based cytology, you may be referred for a colposcopy to have a biopsy taken. This is usually done in a hospital outpatient clinic. Some hospitals do not have the facilities for colposcopy and you may have to visit a more specialised hospital in your area.

A colposcope is like a small microscope with a light and allows the nurse or doctor to make a more thorough examination of the abnormal cells on the cervix.

Before your test you will be helped to position yourself on the couch. In the same way as when you had the screening test, the nurse or doctor will use a speculum to hold the vaginal walls open. The doctor or nurse may repeat the screening test. A liquid is then dabbed onto the cervix to make the abnormal areas show up more clearly. A light is shone onto the cervix and the nurse or doctor looks through the colposcope to examine the areas in detail. A small sample of surface cells (a biopsy) is then taken from the cervix for examination under a microscope by a pathologist.

This can be uncomfortable and may cause a feeling like a period pain, but the test only takes a few minutes. You may have some slight bleeding for a few days afterwards.

This is often used to remove the area of the cervix that contains the abnormal cells, which can then be examined under a microscope in the laboratory. The area of the cervix where abnormal cells are most likely to develop is known as the transformation zone. LLETZ is usually carried out under local anaesthetic. It uses a thin wire to cut away the affected area and may feel uncomfortable. It is usual to have slight bleeding or discharge for a few days after this treatment and you may be asked not to use tampons or have sexual intercourse for a month.

If the abnormal area can't be seen properly with the colposcope, you may have a cone biopsy. This is often done under local anaesthetic, although you may need a general anaesthetic and an overnight stay in hospital.

A small cone-shaped section of the cervix, that is aimed to be large enough to remove any abnormal cells, is taken for examination under a microscope by a pathologist. Various methods can be used to do this.

If there is just a very small growth of cancer cells (microinvasive cancer), the cone biopsy may remove it all so that no further treatment is needed. If the cone biopsy has not removed all of the cancer cells, it is still helpful for your diagnosis, and will help the doctors to decide on the right type of treatment for you.

After the cone biopsy a small gauze pack may be put into the vagina to prevent bleeding. This is usually removed within 24 hours. You may also have a thin tube, called a catheter, put into your bladder so that you can pass urine while the vaginal pack is in place. It is normal to have some light bleeding for a few days after a cone biopsy. Strenuous physical activity and sexual intercourse should be avoided for 4–6 weeks to allow the cervix to heal.

It may take some time for you to get the results of the cone biopsy. It is helpful for you to have a definite arrangement with your gynaecologist about when and how you will be given any further news about the need for more treatment or tests. It is a difficult time for most women and you may need support from family, friends or support organisations while you are waiting for the results.