The reason women have pap smears is to detect pre-cancerous changes in the surface of the cervix so they can either be watched or treated, depending on how far down the road to cancer they’ve gone.
The condition is called Cervical Intraepithelial Neoplasia or CIN. If CIN is graded at a 2 or 3 then the abnormal tissue needs to be removed. The two techniques available for this procedure are ablation, which destroys the tissue, or a cone biopsy, which cuts it out.
The cervix, being the neck of the womb, is critical in pregnancy – holding back the baby until it’s the right time for delivery. A weakened cervix can put women at risk of having a premature baby and it’s been suspected for a long time that treating CIN raises that risk. Others argue that just having a human papillomavirus infection causing CIN is the problem, not treatment of it.
A study bringing together all the available information on this has come up with answers that allow women with CIN to have a meaningful conversation with their doctor. It turns out that it’s true that CIN in its own right increases the risk of preterm delivery, but it is also true that treating CIN raises the risk even further.
In spite of all this CIN does have to be removed or destroyed. You don’t want to develop cervical cancer. It’s a nasty disease.
There’s no difference in risk between ablation and cone biopsy, however it’s important for the doctor to remove just enough tissue to do the job without going too deeply but not too little so they have to repeat the procedure which increases the risk even more.