How to talk to patients about colposcopy  

Being referred for colposcopy can be scary for patients. Your role in explaining what happens at colposcopy is crucial in offering support and encouraging attendance. We’ve put together some tips to help you talk to patients about colposcopy.

Helping people understand why they’ve been referred to colposcopy

It’s important to help patients understand why they’ve been referred to colposcopy. The most common reasons are: 

• Cervical screening results found high-risk HPV and cell changes that need closer examination – this allows monitoring and, if needed, treatment, to prevent cancer developing in the future. 

• Three consecutive positive HPV tests requiring closer examination of the cervix.

• A combination of either two consecutive HPV unavailable or inadequate cytology results.

• On examination, the cervix looks abnormal or there are specific symptoms that require investigation.

• A patient has presented to their GP with a symptom that requires colposcopy, most commonly post-coital bleeding.  

Managing patient anxiety

Many patients will feel anxious about the process. You can help them by acknowledging their worries, explaining why they’ve been referred, and providing realistic timeframes, so they know what to expect. Common fears include: 

• “I must have cancer” – reassure them that cancer is rarely found at colposcopy. The cervical screening programme is designed to look for pre-cancerous changes to help prevent cancer from developing rather than detect cancer.  

• “The referral means something is seriously wrong” – explain it’s a precautionary measure.

• “I’ll need major treatment” – say that many patients need no treatment.  

Preparation guidance for patients 

You can help patients prepare by advising them to avoid sex, tampons, or vaginal medications for at least 24 hours beforehand (If they’re using vaginal oestrogen, this needs to be stopped a week before the colposcopy). Advise them to bring a period pad as there may be light bleeding or discharge afterwards. And encourage them to bring a friend, partner or family member with them for emotional support if they would find this helpful. 

Supporting specific patient groups 

Some patients may need more support. You can: 

• Encourage the patient to inform the colposcopy clinic if they have any specific accessibility requirements, to ensure the appropriate facilities and support are available. 

• Encourage the patient to inform the clinic if they have particular pronouns that they would like to have used and include this in a referral letter if you are referring the patient directly.  

• Encourage your patient to ask any questions that they have when they see the healthcare professional. Encourage them to write them down beforehand, so they don’t forget anything.Advise that if their period is due on the day of their appointment, they should contact the colposcopy clinic to see if the appointment date needs to be changed. 

• Ensure they know they can stop the procedure at any time. 

Final steps 

After explaining the referral to colposcopy, you should: 

• Check understanding and ask if they have questions about what you’ve explained 

• Offer ongoing support by letting them know who to contact with any questions or concerns. 

How to answer common patient questions about results and treatment options 

Primary care staff often receive follow-up calls from patients who have questions about their colposcopy results or upcoming treatment. Here are common questions and suggested responses to help you provide reassurance and guidance.