In the UK, cervical screening (also known as a smear test) saves thousands of lives from cervical cancer. It prevents 70% of cervical cancer deaths: a number which could be higher if more screenings were attended.

Women and people with cervixes are usually invited to get their first smear at 25, and again every three years until they’re around 49. From 50-64, they are invited every five years.

Are you due a cervical screening? We’re here to explain the screening and what to expect when you attend one.

What is cervical screening?

Cervical screening has shown to help prevent cancer in women and people with a cervix. It’s a simple test that checks for certain types of human papillomavirus (HPV) that can change the cells of your cervix, also known as ‘high risk’ HPV.

Keep in mind, cervical screening isn’t for people with symptoms. If you experience any symptoms listed below, speak to a GP:

• vaginal bleeding in between your periods, after sex or after the menopause
• changes to vaginal discharge (including appearance or smell)
• pain or discomfort during sex
• unexplained pain in your lower back or between your hip bones (pelvis).

Why is it important to get a cervical screening?

There are just under 3,200 new cervical cancer cases in the UK every year, with a peak incidence between 25-29 years.

Scientific studies show that cervical screening  saves more than 4500 lives every year in England alone, by identifying lesions at early stages. It is estimated that the initial changes identified in the screening (CIN or microinvasive) will take 10-20 years to develop to cervical cancer, and 99.8% of cervical cancer is preventable.

Cervical cancer often has no symptoms in the early stages, so it is really difficult to identify without the screening.*

What happens during the screening?

The appointment will last about 10 minutes, while the test itself will take about 5 minutes. Remember that you always have the right to ask for a chaperone or someone of your choice with you during the appointment, should this make you feel more comfortable.

The nurse will ask you to go behind a screen and get undressed; they will give you a sheet to put over you. When you are ready, the nurse will ask you to lie on your back with your legs bent and your feet together. They will insert a tube-shaped tool (speculum) into your vagina; a small amount of lubricant may be used. The nurse will gently open the speculum to see your cervix and, using a soft brush, will take a small sample of cells from your cervix. The speculum will then be closed and removed.

What is HPV?

HPV stands for Human Papilloma Virus. There are several HPV type and some of them are linked to cervical cancer. HPV infections spread primarily through sexual contact, and the infection itself does not cause any symptoms.

Almost 40% of sexually active women have a HPV infection within 2 years of their first sexual intercourse, but 90% of these infections clear within 2 years without any consequence. On the other hand, a persistent HPV infection that does not clear by itself does not necessarily mean there is cancer, but it does increase the risk.

HPV infection is found in 99.7% of cases of cervical cancer.

What is 'high risk' HPV?

Most people have HPV at some point in their lives and it clears up pretty easily. Sometimes HPV persists and cells in the cervix become abnormal – which can turn into cancer. Almost all cervical cancer is caused by ‘high risk’ HPV.

Cervical screening checks for abnormal cells before they turn cancerous, which is why it’s important to attend your routine screening. But it’s important to remember, they’re not tests for cancer.

Why do you have to wait until you're 25?

Cervical cancer is very rare in under 25s. Abnormal cells can return to normal in younger women and people with a cervix, so earlier screening isn’t necessary.

How wide does a speculum open? 

The medium speculum is about 1 inch (2.5 cm) width when it is close, and it will open about further 0.8 inch (2 cm).

There are difference sizes of speculum available, and the nurse will select the most appropriate one for you; however, if you find the examination uncomfortable, you can always ask to switch to a smaller one.***

Does it hurt?

Most people don’t find it painful, but others can feel some level of discomfort. Everyone is different. But if you’re concerned, you can always speak to your healthcare professional. 

What if the results are abnormal?

You’ll receive a letter detailing your results. You may have HPV with no abnormal cells, in which case you’ll be invited sooner than 3 years to check you have cleared the infection.

If your results show you have HPV with abnormal cells, you’ll usually need to have another test called a colposcopy: a simple procedure to look at your cervix and they may take a small sample. Your doctor will tell you if this is necessary.

I have more questions about cervical screening

If you would like to speak to a clinician about cervical screening, you can always book an appointment with one of our GPs and Advanced Clinical Practitioners (ACPs). Our clinicians are here 24/7, whenever you need them.

* https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer

** https://vk.ovg.ox.ac.uk/vk/hpv#:~:text=Key%20disease%20facts&text=Before%20vaccination%20started%20in%202009,Research%20UK's%20cervical%20cancer%20statistics%20

*** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101979/