The short answer
A colposcopy is a follow-up procedure after an abnormal Pap or HPV test. The doctor uses a lighted magnifying tool to look closely at the cervix and usually takes a small tissue sample (biopsy). NCI says most people with an abnormal result do not have cancer. It is a way to check cell changes carefully.
A colposcopy is a follow-up exam after an abnormal Pap or HPV screening result.
The doctor uses a lighted, magnifying instrument called a colposcope to look closely at the cervix.
It usually includes a biopsy — a small tissue sample checked under a microscope.
NCI says most people with abnormal screening results do not have cancer.
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This page is for anyone who has been told they need a colposcopy. It explains what the test is, what happens during it, and what the results mean.
The simple version
A colposcopy is a follow-up procedure. Your doctor may recommend one after an abnormal Pap or HPV test. It lets them take a closer, magnified look at the cervix to understand what the screening result found.
Here is the most important thing to know first. NCI says most people with abnormal screening results do not have cancer. Screening is built to catch changes early, and a colposcopy is simply the next careful step to see those changes up close.
A colposcopy is a closer look after an abnormal result. Most people with an abnormal result do not have cancer.
Why it's recommended
Pap and HPV tests are very good at flagging when something needs a closer look. But they cannot show exactly what is going on. A colposcopy fills in that picture. Your doctor may recommend one to find out whether cell changes are:
- Minor, and likely to go away on their own, or
- More significant, and worth treating early to prevent cancer
Your screening result, your age, and your past history all help decide whether a colposcopy is the right next step.
What happens during the procedure
A colposcopy starts much like a Pap test. Here is the sequence:
- You lie on an exam table and the doctor inserts a speculum to see the cervix.
- A vinegar-like solution goes on the cervix, which makes abnormal areas easier to see.
- The doctor places a colposcope near the vagina to look closely. A colposcope is a magnifying instrument with a bright light.
The colposcope stays outside your body. The exam is usually not painful, though you may feel some pressure.
The biopsy
A colposcopy usually includes a biopsy. A small sample of cervical tissue is removed and checked under a microscope. This is how your doctor learns exactly what the cell changes are.
When the sample is taken, some people feel a brief pinch or a cramp, much like a menstrual cramp. Light bleeding or discharge for a short time afterward is common. Ask your provider how long to avoid tampons, anything in the vagina, and sex. MedlinePlus says several days to a week.
How results are reported
Biopsy results are often described with the term CIN, which stands for cervical intraepithelial neoplasia. It is graded from 1 to 3, based on how abnormal the cells look and how much tissue is affected:
- CIN 1 — mild changes, which usually go away on their own without treatment.
- CIN 2 — moderate changes, often treated by removing the abnormal cells. They can sometimes clear up on their own.
- CIN 3 — severely abnormal changes. Doctors do not yet know which ones will become cancer, so they are usually treated right away, unless you are pregnant.
Your doctor will explain your own grade and what it means for you.
What treatment can involve
Sometimes the biopsy shows more significant changes, meaning CIN 2 or CIN 3. Then treatment aims to remove or destroy the abnormal cells that have a high chance of becoming cancer.
Your care team will walk you through the options and what to expect. They will also cover anything special in your case, such as being pregnant or planning to become pregnant. NCI says it is important to get the follow-up care your provider recommends.
Treating abnormal cells early aims to stop them from becoming cervical cancer.
When to get help sooner
Some bleeding and discharge after a biopsy is expected. These signs are not.
Call 911 or go to an emergency department if you have any of these:
- Bleeding is very heavy and keeps going.
- You pass large clots.
- You feel faint, dizzy or short of breath.
Heavy blood loss needs help straight away, not a message left with the clinic. Do not drive yourself.
Call your care team right away, at any hour, if you have any of these (MedlinePlus says to contact your provider right away):
- Bleeding after the biopsy is heavier than your usual period, or it lasts longer than 2 weeks.
- You have pain in your belly or pelvis.
- You have a fever.
- The discharge smells foul.
If you are having chemotherapy, have had a stem cell transplant or CAR T, or have low white cells, call right away, day or night, for a temperature of 100.4°F (38°C) or higher, chills, or any other sign of infection, even without a fever.
Common questions
Why do I need a colposcopy?
A colposcopy is recommended when a Pap or HPV test result is abnormal and your doctor wants a closer look at the cervix. It helps find out whether the cell changes are minor or more significant. NCI says most people with an abnormal result do not have cancer. A colposcopy is a careful way to check.
What happens during a colposcopy?
You lie on an exam table as for a Pap test. The doctor inserts a speculum to see the cervix, then applies a vinegar-like solution that makes abnormal areas easier to spot. A colposcope — a magnifying instrument with a bright light — is placed near the vagina so the doctor can examine the cervix closely. It stays outside the body.
Will I have a biopsy?
A colposcopy usually includes a biopsy, where a small sample of cervical tissue is removed and checked under a microscope. This is how the doctor learns exactly what the cell changes are. You may feel a brief pinch or cramp when the sample is taken.
Does a colposcopy hurt?
The exam itself is usually not painful, though you may feel pressure. If a biopsy is taken, some people feel a brief cramp, like a menstrual cramp. Afterward, light bleeding or discharge is common for a short time. Your doctor will tell you what to expect and how to care for yourself.
What do the results mean?
Biopsy results are often reported as CIN (cervical intraepithelial neoplasia), graded 1 to 3. CIN 1 changes are mild and often go away on their own. CIN 2 and CIN 3 are more significant and may be treated to prevent cancer. Your doctor will explain your specific result and any next steps.
What if the biopsy shows serious changes?
CIN 2 is moderate and is typically treated by removing the abnormal cells. CIN 3 is severely abnormal. Doctors do not yet know which CIN 3 changes will become cancer, so CIN 3 is usually treated right away unless you are pregnant. Treatment removes or destroys the abnormal cells before they can become cancer.
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
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