In the national cervical cancer screening programme, eligibility is split by even and odd birth years, and in 2026 it is the turn of women aged 20 and over who were born in an even-numbered year.
The phrase 'negative, reactive cell change' on a result sheet can be alarming, but it does not mean cancer cells. It means the cervix has reacted to irritation or inflammation and its cells have changed shape slightly. This article explains what that means, how it relates to HPV, how CIN progresses through its stages, and what to look for when choosing where to be seen.
What exactly does a reactive cell change mean?
Cervical cells can change shape slightly as they try to protect themselves from irritation or inflammation, much like getting a mouth ulcer when you are tired. If there are no symptoms, it is fine to check again at the next routine screening.
When increased discharge, odour or itching come with it, the cause in most cases is vaginitis, so a test for the organism is needed, followed by treatment of the inflammation. Screening only checks for cell abnormalities, so symptoms call for separate tests and treatment.
- No symptoms — if there are no particular symptoms, checking again at the next routine screening is enough
- Discharge or odour — if discharge increases and there is an odour, mild vaginitis should be suspected and a test for the organism carried out
- Itching — when itching appears as well, it is in many cases managed with treatment of the inflammation after a test for the organism
How is it related to HPV infection?
The cell test used in screening only shows abnormal changes and cannot detect HPV infection itself, so if the cell change has not gone away on a repeat test, a separate HPV test is in many cases carried out. If high-risk HPV is found, that in itself needs management and treatment.
HPV infection does not mean cervical cancer, but the risk should be understood early and dealt with. A reactive cell change left without follow-up can progress to atypical squamous cells, so checking at this point shapes what happens next.
What stages do cell changes go through as they progress?
CIN1, a low-grade dysplasia, has a high chance of resolving naturally, so it is followed at intervals of 6 months to 1 year to watch for change. CIN2 and CIN3 are high-grade dysplasia, and because progression leads to stage 0 cancer (carcinoma in situ), treatment is recommended in advance.
From CIN2 upward, a cone excision called LEEP is carried out in many cases. In practice it is closer to a procedure in which the altered area is cut away slightly in a cone shape and removed. Understanding the stage on the result sheet makes it possible to judge whether follow-up is needed or whether it is time for treatment.
- CIN1 — low-grade dysplasia that may resolve naturally, so follow-up tests are carried out at intervals of 6 months to 1 year
- CIN2 and CIN3 — classified as high-grade dysplasia, the stage at which active treatment is recommended
- Stage 0 cancer (carcinoma in situ) — the stage diagnosed when changes progress beyond the CIN stages; treatment is needed
- LEEP (cone excision) — a procedure in which the altered area is cut away slightly in a cone shape and removed
Where should care continue after screening?
Because the tests needed and the way to respond differ by stage, getting specific guidance on the current situation and on the timing of follow-up and repeat tests matters more than simply hearing 'it is negative'. That is what allows a person to manage the condition properly without missing the right time for treatment.
Vaginitis needs medication prescribed to match its cause, and if HPV persists or the result is CIN2 or above, management after treatment such as cone excision is needed to prevent recurrence and protect fertility. Missing changes from stage to stage can sometimes end in a cancer diagnosis.
- Specific explanation — patients should be told specifically what stage the current cell change is at
- Repeat test timing — if follow-up is needed, the interval for repeat tests should be clear
- Tailored treatment — vaginitis calls for medication that matches its cause, and HPV-related stages call for treatment that matches the stage
- Aftercare — care needs to continue after treatment to prevent recurrence and protect fertility
