CIN has returned after LLETZ - what's my risk of cancer?

[FilmFan2013]

I have a few questions as I haven't had a normal smear since 2008 which is when I first had an abnormal smear result (mild). I kept having abnormal smears (mild) but then had LLETZ in 2011 when the smear showed moderate changes, and the histology was CIN2 with clear margins. I was told LLETZ is a successful treatment but my first post-LLETZ showed abnormal smear (mild). Colposcopy biopsy has shown CIN1. I've continued to have this ever since so I'm still having abnormal smears.

My questions are:
1. What are my chances of this becoming cervical cancer if LLETZ didn't work and I'm still having abnormalities?
2. As I've had CIN1 since 2011 after LLETZ can I ask for it to be removed if it continues?
3. I haven't had a HPV test, they're only doing it in my areas for new patients, so should I pay privately for one?
4. I've just started a new relationship, will condoms protect against HPV from my new partner and if he does infect me can this increase my cancer risk?


Thank you very much.

[Dr Amanda Tristram]

I will try and answer you questions:
1. What are my chances of this becoming cervical cancer if LLETZ didn't work and I'm still having abnormalities?
The risk of getting cervical cancer after LLTZ is about 1.5%. This is an overall figure and I can't give you a precise figure for your situation. It is fairly common to need repeat treatment after a LLETX - it happens to about 1 in 20 women. So needing repeat treatment is much more common than getting cancer.
2. As I've had CIN1 since 2011 after LLETZ can I ask for it to be removed if it continues?
Yes. You should certainly talk to them about this.
3. I haven't had a HPV test, they're only doing it in my areas for new patients, so should I pay privately for one?
As a biopsy has already shown CIN 1, it is unlikely that a positive HPV test would change your management. If the test was positive, you would go for a biopsy, which you've already had. If the test was negative, you would have to decide whether to trust that and ignore the biopsy - which would be unwise.
4. I've just started a new relationship, will condoms protect against HPV from my new partner and if he does infect me can this increase my cancer risk?
Condoms give excellent protection against lots of sexually transmitted infections. However, they do not protect 100% against HPV. Having said that, HPV is really common and your partner has probably already been exposed. Men are much less likely to be affected by it and only need to seek medical advice if they can see an abnormal area of skin or are having symptoms such as pain or itching.