Tell me about cervical screening (smear tests)

A smear test is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix. Regular smear testing is the best way of detecting changes in the cells of the cervix that could go on to develop into cervical cancer. Thanks to smear testing there are now less cases of cervical cancer.²²

So although smear tests do not detect infection with the virus that causes cervical cancer, they do help find changes in cells so that treatment can be started, if needed. Many lives have been saved because the disease has been caught at an early stage as a direct result of cervical screening.^6,22 Finding and treating abnormal cells early on can prevent 75 per cent of cancers developing but, like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer.²⁹

Even if you have had the HPV vaccine you still need to attend cervical screening when invited as the vaccination will only protect you against two types of the HPV virus that cause 70% of cervical cancers.¹⁶

So, whatever you do, remember to make your smear test appointment when you are invited by your GP surgery.

When will I be invited for cervical screening?

The age and frequency that women are invited for screening depends on where you live in the United Kingdom:¹⁷

England

25-49 years old - every three years
50-64 – every five years

Northern Ireland

20-64 years old - every three to five years

Scotland

20-60 years old - every three years

Wales

20-64 – every three years

What happens at cervical screening?

During a smear test a doctor or nurse will take some sample cells from your cervix which is located at the neck of the womb at the top of the vagina. They do this by gently putting an instrument called a speculum into the vagina so that they can see the cervix clearly. Cells are brushed or wiped off the surface of the cervix using a special soft brush. The sample cells will be sent away to a laboratory to be examined under a microscope for possible abnormal cells. If any abnormalities are found, you will be contacted about any further tests or possible treatment.²⁴

Smear tests only take about 5 minutes, and most women agree that, although perhaps a little uncomfortable or embarrassing, they do not hurt and are over very quickly.²⁴

Smear test results

Smear tests allow doctors and nurses to find – and then treat if required – any abnormal cells on the cervix which could have gone on to develop into cervical cancer over time.²⁴ This is why it is important that you attend any follow-up smear tests or appointments your doctor or nurse might suggest.

If the results of your smear test are 'abnormal', it’s natural to feel worried. However, it’s important to remember that there can be many other reasons for the result such as inflammation or infection. If you are still worried, talk to your doctor or nurse.²⁴

Understanding your smear test results:

Abnormal

You may have been told that you have an 'abnormal result'. This means that the laboratory found some abnormal cells from the sample taken from your cervix. It’s natural to feel worried when you are told the result is abnormal.²⁴

However, it’s important to remember that there can be many other reasons for the result such as inflammation or infection. If you are still worried, talk to your doctor or nurse²⁴. Smear tests allow doctors and nurses to identify – and then treat if required – any abnormal cells on the cervix which could develop into cervical cancer. And just because the cells are abnormal doesn't necessarily mean that you need treatment – many abnormalities clear themselves spontaneously.²⁴

You may be asked for a second smear test or, in some cases, you may be referred for a colposcopy (see below). Your doctor or nurse will advise you on what happens next and will be able to answer any questions you have.²⁴

Borderline

If you have been told you have a 'borderline' smear result, again do not worry. This means that the laboratory did see some kind of abnormal cells in the sample, but that they were so near to normal that it is likely that they will soon return to normal. In this case, you will probably be asked to return for a smear test after 6-12 months.²⁴

Inadequate

Some women are told they have an 'inadequate result.' This means that the laboratory was not able to assess the cells. There are many reasons for this: it could be that some blood obscured the cells or not enough cells were in the sample or the cervix was inflamed and so the cells could not be seen clearly enough. In these cases, you will probably be asked back for a second smear.²⁴

Colposcopy

If you have an abnormal smear test result, your doctor may send you for a colposcopy at the local hospital.²⁴

A colposcopy is done by specially trained doctors or nurses with an instrument called a colposcope – a powerful, illuminated microscope which allows the doctor or nurse to examine your cervix more closely. It’s a similar procedure to a smear test in that the doctor or nurse will use a speculum to open your vagina to see your cervix more closely. This allows them to assess the extent of the abnormal cells on the cervix and to decide on the appropriate treatment for you.³⁰

Sometimes, a sample of tissue (called a biopsy) may be taken from the cervix for further diagnosis, or sometimes the cervix is actually treated at this time. Alternatively, you might simply be asked to return for a follow-up smear.³⁰

If you feel worried, or have any more questions, always talk to your doctor or nurse.