the patient had been putting off her smear for four years. She had no symptoms and felt healthy. The Pap smear found a high-grade cervical abnormality — CIN2. A LLETZ procedure fully removed it. Without that smear, it could have progressed to cervical cancer within 3–5 years.
Housewife. Presented for her first Pap smear in 4 years. No symptoms — no abnormal bleeding, no discharge. Pap smear result: high-grade squamous intraepithelial lesion (HSIL) — corresponding to CIN2. Referred for colposcopy. Biopsy: CIN2 confirmed. Treated with LLETZ (large loop excision). Histology: fully excised, clear margins.
Pap Smear (Cervical Smear)the patient's last Pap smear had been in 2021 — result normal. She had been told to repeat in 3 years. Three years became four, then almost four and a half. There was always a reason to delay: her children's school fees, a family event, a period that had just finished making the timing inconvenient. She felt perfectly well. There was nothing wrong.
She finally came to Mascot Healthcare for a general well-woman check in response to her younger sister's cervical cancer diagnosis in Abuja. "If Adunola can get it at 38," she told the receptionist, "maybe I shouldn't keep putting mine off." The doctor performed the smear in 5 minutes — a small discomfort and some slight spotting. The result was returned in 5 days.
"The smear has shown a high-grade abnormality," the doctor said on the phone. "This is called CIN2. It is a precancerous change — not cancer. But it needs to be treated. I am referring you for a colposcopy appointment this week."
A Pap smear (cervical smear) collects cells from the cervix and examines them for abnormal changes caused by HPV infection. It detects precancerous changes (CIN1, CIN2, CIN3) years before they develop into cancer — giving a window of curative treatment.
No intraepithelial lesion or malignancy — routine re-screen in 3 years.
Low-grade changes — often resolve spontaneously; monitored with repeat smear in 6–12 months.
High-grade changes — significant HPV-driven cellular abnormality. Risk of progression to cancer: 20–30% over 5 years without treatment. the patient's result.
Severe precancerous change — high risk of progression; requires immediate colposcopy and treatment.
Cancer cells present — requires immediate oncology referral and staging.
CIN2 does not cause symptoms. the patient would have had no way of knowing it was there without the smear. Without treatment, CIN2 progresses to CIN3 (severe precancerous change) in approximately 20–30% of cases over 5 years — and from CIN3 to invasive cervical cancer in a further proportion of untreated cases.
The window between a normal Pap smear and invasive cervical cancer is typically 10–15 years — which is why 3-yearly screening in women aged 25–65 is so effective. the patient had been in the window. The smear caught the abnormality while it was still at the treatable stage.
Colposcopy was performed within 10 days of the abnormal smear: the cervix was examined under magnification with acetic acid (turns abnormal cells white) and Lugol's iodine (stains normal cells brown). A 3 × 2 cm white area was identified in the transformation zone. Biopsy: CIN2 confirmed on histology.
LLETZ (large loop excision of the transformation zone) was performed under local anaesthetic — a same-day outpatient procedure taking 20 minutes. The abnormal area was excised with a fine wire loop. The excised specimen was sent for histology: CIN2 confirmed, excision complete, clear margins on all sides.
Post-LLETZ: repeat smear at 6 months (result: normal) and co-testing (smear + HPV testing) at 12 months (both negative). the patient was returned to routine 3-yearly screening.
Pap smear: HSIL. Colposcopy biopsy: CIN2. LLETZ: complete excision, clear margins. 6-month smear: normal. 12-month co-test: negative.
Immediate colposcopy referral; LLETZ excision; histology confirmed complete excision; repeat smear at 6 months; co-testing at 12 months.
6-month smear: normal (NILM). 12-month HPV co-test: HPV negative, smear normal. Returned to 3-yearly routine screening.
CIN2 fully excised. No recurrence at 12 months. the patient describes the smear as "the appointment I almost skipped" — and now brings her daughters for HPV vaccination.
CIN2 — a high-grade precancerous change — causes no symptoms. Feeling well is not a substitute for a Pap smear. A 5-minute test every 3 years detects the abnormality in the window where it is 100% treatable.
In Nigeria, most cervical cancer is diagnosed at a late stage because screening uptake is low. A Pap smear at Mascot Healthcare is the most effective cancer prevention investment a woman can make.
A Pap smear takes 5 minutes and finds changes that are silently developing into cancer — years before they become cancer. Three years between smears. Don't let it become four.
Book online or via WhatsApp — same-day results on most tests, transparent pricing.