Cervical Screening: Breaking the Stigma and Understanding the Importance

In the UK, cervical screening (also known as a smear test) plays a crucial role in saving lives by preventing cervical cancer. According to the NHS, cervical screening helps prevent 70% of cervical cancer deaths, a figure that could be even higher if more people attended their screening appointments.

Typically, women and people with cervixes are invited for their first smear test at 25, followed by screenings every three years until they are around 49. From ages 50 to 64, screenings are offered every five years.

To clarify the current schedule: the NHS now invites everyone for screening every 5 years from age 25 to 64, rather than the 3-then-5-year pattern above — you may be recalled sooner if high-risk HPV is found.

Are you due for your cervical screening?

If you're unsure about when your next screening is, we're here to explain what cervical screening is, why it’s important, and what to expect when you attend. Let's break down the key information surrounding this life-saving procedure.

What is cervical screening?

Cervical screening is a preventative measure designed to identify high-risk HPV (human papillomavirus) strains that can cause changes in the cells of your cervix. This test is essential because certain types of HPV can increase the risk of cervical cancer, especially if left unchecked.

It’s important to note that cervical screening is not a test for cancer. If you are experiencing any symptoms such as unusual vaginal bleeding, changes in discharge, pain during sex, or unexplained pain in the pelvic area, it's important to see a GP. Cervical screening is aimed at people who are asymptomatic, to prevent potential issues before they develop into something more serious.

Cervical cancer symptoms to watch for

The main symptoms to look out for are unusual vaginal bleeding, discharge that smells unpleasant, pain during sex, and persistent pelvic pain, according to NHS guidance.

• Unusual vaginal bleeding — after sex, between periods, or after the menopause
• Vaginal discharge that smells unpleasant
• Pain during sex
• Persistent pelvic pain
• Never had any sexual contact: your risk of HPV is low, so you may choose not to attend, though you’re still welcome to
• Pregnant: routine screening is usually delayed until after you’ve had your baby
• Had a hysterectomy: whether you still need screening depends on the type of operation and the reason for it — check with your GP if you’re unsure

These symptoms have many causes that are far more common than cervical cancer, so try not to worry — but as above, cervical screening is for people without symptoms, so see a GP promptly if you notice any of these rather than waiting for a screening invitation. Our guide to sexual health covers more on symptoms worth getting checked, and regularly checking your breasts is another simple habit worth building — our guide to being breast aware covers what to look out for.

Why is cervical screening important?

Every year in the UK, almost 3,200 new cases of cervical cancer are diagnosed, with the highest rates of incidence occurring between the ages of 30-34. Studies have shown that cervical screening saves more than 4,500 lives each year in England by detecting early signs of cervical abnormalities.

Cervical cancer often develops without any noticeable symptoms, making it difficult to detect in its early stages. With the help of cervical screening, abnormal changes in the cervix can be caught early, giving people the best possible chance of preventing cancer. Cervical screening helps detect these changes long before they may develop into cancer, making early intervention possible.

What happens during a cervical screening?

The cervical screening procedure is relatively quick, lasting about 10 minutes, with the actual test taking only around 5 minutes. Here’s what you can expect:

• The nurse will guide you to a private space to undress from the waist down and cover yourself with a sheet.
• You’ll be asked to lie back with your knees bent and your feet together.
• A speculum (a small tube-shaped tool) will be gently inserted into your vagina to allow the nurse to access your cervix.
• A soft brush will then be used to take a small sample of cells from your cervix, which will be sent to a lab for analysis.

It’s important to remember that you can always ask for a chaperone if you’d like someone with you during the procedure to make you feel more comfortable.

What is HPV and why does it matter?

HPV (Human Papillomavirus) is a virus commonly spread through sexual contact. While many types of HPV cause no symptoms and clear up naturally, certain "high-risk" strains can lead to abnormal cell changes in the cervix, potentially leading to cervical cancer if left untreated.

Around 99.7% of cervical cancer cases are linked to high-risk HPV infections, making it essential to detect and monitor HPV through regular cervical screenings. If you have HPV, it doesn't automatically mean you will develop cancer, but it’s crucial to monitor it closely.

What is 'High Risk' HPV?

Most people will encounter HPV at some point in their lives, and it often clears up on its own without causing any harm. However, if the virus persists, it can lead to abnormal cell changes on the cervix, which may increase the risk of cancer. High-risk HPV types are specifically linked to cervical cancer, which is why cervical screening is vital for identifying abnormal changes early.

Remember, cervical screening is not a test for cancer—it’s a way to identify and treat abnormal cells before they have the chance to develop into cancer.

The HPV vaccine and why you still need screening

The HPV vaccine is offered to girls and boys aged 12 to 13 in England, and an English study found it cut cervical cancer rates by almost 90% in women offered it at that age, according to Cancer Research UK. It doesn’t cover every high-risk HPV type, though, so anyone who has had the vaccine still needs to attend cervical screening from age 25 when invited.

Why wait until you’re 25 for your first cervical screening?

Cervical cancer is very rare in individuals under the age of 25, and younger people with cervixes often experience natural changes in their cervical cells, which can return to normal without intervention. Because of this, the NHS recommends starting cervical screening at the age of 25, when the likelihood of cancer is still low, and abnormalities are more easily treated.

Who is invited, including less common situations

Screening is offered to everyone with a cervix aged 25 to 64, including trans men and non-binary people assigned female at birth. 

Does it hurt? What should you expect?

For most people, a cervical screening is not painful, but it may feel a little uncomfortable. Everyone’s experience can be different, and some people may feel a slight discomfort during the procedure. If you are concerned, don’t hesitate to speak to your nurse or doctor, who will try to make the procedure as comfortable as possible. If necessary, you can ask for a smaller speculum if you find the procedure uncomfortable.

Home HPV self-sampling kits

As part of the government’s 10 Year Health Plan, under-screened people in England — those who are significantly overdue or have never attended — are starting to be offered HPV self-sampling kits, letting them collect their own sample at home in private and post it back for testing. This is being rolled out region by region rather than being available to everyone yet, so it’s worth checking with your GP practice whether it applies to you. A positive result on a self-sampling kit still means booking a follow-up clinician-taken screening test.

What happens if your results are abnormal?

If your results come back showing HPV without abnormal cells, you may simply need to come back for another test in a shorter timeframe (usually within 12 months). If abnormal cells are found, the next step will usually be a colposcopy, which is a more detailed examination of the cervix. A sample of tissue may be taken during the colposcopy for further analysis.

It’s important to note that having abnormal cells doesn’t mean you have cancer. In most cases, abnormal cells can be treated effectively before they develop into something more serious.

Need more information on cervical screening?

If you still have questions about cervical screening, you can always speak to a healthcare professional. You can book an appointment with one of our experienced GPs or Advanced Clinical Practitioners (ACPs), who are available 24/7 to discuss your concerns and help you with any questions about the screening process.

Conclusion

Cervical screening is a vital part of staying healthy, helping to detect early signs of cervical cancer and prevent it before it can develop. By attending your routine screenings, you can protect your future and reduce your risk of cervical cancer. If you are due for a screening, don’t delay—book your appointment today and take control of your health.