Cervical screening (a smear test) checks the health of your cervix. The cervix is the opening to your womb from your vagina.
It's not a test for cancer, it's a test to help prevent cancer.
All women and people with a cervix aged 25 to 64 should be invited by letter.
During the screening appointment, a small sample of cells will be taken from your cervix.
The sample is tested for changes to the cells of your cervix.
Finding abnormal changes early means they can be monitored or treated so they do not get a chance to turn into cervical cancer.
You'll get your results by letter, usually in about 2 weeks.
Cervical screening is one of the best ways to protect yourself from cervical cancer.
Cervical screening checks the health of your cervix. It's not a test for cancer, it's a test to help prevent cancer.
How cervical screening helps prevent cancer
Cervical screening may check for:
abnormal cell changes in your cervix – left untreated, this could turn into cancer
HPV – some types of HPV can lead to cell changes in your cervix and cancer
What is HPV?
Human papillomavirus (HPV) is the name for a very common group of viruses.
You can get it from any kind of skin-to-skin contact of the genital area, not just from penetrative sex.
Most people will get some type of HPV during their lives.
Nearly all cervical cancers are caused by infection with certain types of HPV.
Finding cell changes early means they can be monitored or treated. This means they do not get a chance to turn into cervical cancer.
Who's at risk of cervical cancer
If you have a cervix and have had any kind of sexual contact, with a man or a woman, you could get cervical cancer.
You're still at risk of cervical cancer if:
· you have had the HPV vaccine – it does not protect you from all types of HPV, so you're still at risk of cervical cancer.
· you have only had 1 sexual partner – you can get HPV the first time you're sexually active
· you have had the same partner, or not had sex, for a long time – you can have HPV for a long time without knowing it.
· you're a lesbian or bisexual – you're at risk if you have had any sexual contact
· you're a trans man with a cervix – read about if trans men should have cervical screening
· you have had a partial hysterectomy that did not remove all of your cervix
Cervical screening is a choice
It's your choice if you want to go for cervical screening. But cervical screening is one of the best ways to protect you from cervical cancer.
Risks of cervical screening
You may have some light bleeding or spotting after cervical screening. This should stop within a few hours.
If abnormal cells are found and you need treatment, there are some risks, such as:
· treating cells that may have gone back to normal on their own
· bleeding or an infection
· you may be more likely to have a baby early if you get pregnant in the future – but this is rare
How to opt out
If you do not want to be invited for screening, contact your GP and ask to be taken off their cervical screening list. You can ask them to put you back on the list at any time if you change your mind.
All women and people with a cervix between the ages of 25 and 64 should go for regular cervical screening. You'll get a letter in the post inviting you to make an appointment.
When you'll be invited for cervical screening
Age / When you're invited
under 25 - up to 6 months before you turn 25
25 to 49 - every 3 years
50 to 64 - every 5 years
65 or older - only if 1 of your last 3 tests was abnormal
You can book an appointment as soon as you get a letter. If you missed your last cervical screening, you do not need to wait for a letter to book an appointment.
When cervical screening is not recommended
If you're under 25
You will not be invited for cervical screening until you're 25 because:
cervical cancer is very rare in people under 25
it might lead to having treatment you do not need – abnormal cell changes often go back to normal in younger women.
If you're 65 or older
You'll usually stop being invited for screening once you turn 65. This is because it's very unlikely that you'll get cervical cancer.
You'll only be invited again if 1 of your last 3 tests was abnormal.
If you're 65 or older and have never been for cervical screening, or have not had cervical screening since the age of 50, you can ask your GP for a test.
If you have had a total hysterectomy
You will not need to go for cervical screening if you have had a total hysterectomy to remove all of your womb and cervix. You should not receive any more screening invitation letters.
When to book cervical screening
Try to book your appointment as soon as you get invited. If you missed your last cervical screening, you do not need to wait for a letter.
It's best to book an appointment when:
· you're not on your period – also try to avoid the 2 days before or after you bleed (if you do not have periods, you can book any time)
· you have finished treatment if you have unusual vaginal discharge or a pelvic infection
Avoid using any vaginal medications, lubricants or creams in the 2 days before you have your test as they can affect the results.
Things to ask when you book
It's OK to let the GP surgery know if you have any worries about going for cervical screening.
· let them know if you'd like a woman to do the test – most nurses and doctors who take cervical screening samples are female.
· let them know if you'd like someone else to be in the room with you (a chaperone) – this could be someone you know, another nurse or a trained member of staff
· ask for a longer appointment if you think you might need more time – some GPs can offer a double booking
· let them know if you're finding the test more difficult after going through the menopause – they can prescribe a vaginal oestrogen cream or pessary before the test
· ask for a smaller speculum (a smooth, tube-shaped tool that's put into your vagina so they can see your cervix)
· try not to be embarrassed about talking to the nurse or doctor on the day – they're trained to make you feel more comfortable and provide support
During cervical screening a small sample of cells is taken from your cervix for testing.
The test itself should take less than 5 minutes. The whole appointment should take about 10 minutes. It's usually done by a female nurse or doctor. Before starting, they should explain what will happen during the test and answer any questions you have.
How cervical screening is done
You'll need to undress, behind a screen, from the waist down. You'll be given a sheet to put over you.
The nurse will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart.
Sometimes you may need to change position during the test.
They'll gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant should be used.
The nurse will open the speculum so they can see your cervix.
Using a soft brush, they'll take a small sample of cells from your cervix.
The nurse will close and remove the speculum and leave you to get dressed.
You're in control of the screening and can ask the nurse to stop at any time.
Things you can try to make the test easier
If you're worried about cervical screening, there are things you can try that might make the test better for you:
· wear something you can leave on during the test, like a skirt or long jumper
· bring someone with you for support
· breathing exercises to help you relax – ask your nurse about these
· ask the nurse to use a smaller speculum
· ask the nurse about lying in a different position – such as on your side with your knees pulled up to your chest
· bring something to listen to or read during the test
· do not feel pressure to keep going – you can ask to stop the test at any time
· try not to be afraid or embarrassed to talk to the nurse – telling them how you feel will help them understand what kinds of support you might need
Things to look out for after cervical screening
You may have some spotting or light bleeding after your cervical screening test.
This is very common and should go away in a few hours.
Your cervical screening results are usually sent to you in a letter. Sometimes you may be asked to call your GP to get the results.
When your results should arrive
You should get your results within 14 days. But they can take longer to arrive.
If you have waited longer than you expected, call your GP surgery to see if they have any updates.
Try not to worry if your results are taking a long time to get to you.
It does not mean anything is wrong, and most people will have a normal result.
What your results mean
Your results letter will explain what was tested for and what your results mean.
Most people will have a normal result. This means you do not need any further tests and you'll be invited for screening again in 3 or 5 years.
Sometimes you'll be asked to come back in 3 months to have the test again.
This does not mean there's anything wrong – it's because the results were unclear.
If you have an abnormal result
Your results letter should explain what will happen next.
You may need:
· no treatment
· another cervical screening test in 1 year
· a different test to look at your cervix (colposcopy)
There are different kinds of abnormal result depending on if your sample was tested for:
· abnormal cell changes in your cervix – left untreated, this could turn into cancer
· HPV – some types of HPV can lead to cell changes in your cervix and cancer
HPV is a common virus and most people will get it in their life. You can get it through any kind of sexual contact.
Results / What it means
Abnormal with borderline or low-grade cell changes
If no HPV was found, you'll be invited for screening again in 3 or 5 years. If HPV was found, you may need to go for colposcopy.
Abnormal with high-grade cell changes - You'll be asked to go for colposcopy.
HPV found (HPV positive) but no cell changes
You'll be invited for screening again in 1 year to make sure the HPV is gone. If you get this result 3 times in a row, you may need to go for colposcopy.
HPV found (HPV positive) with cell changes - You'll be asked to go for colposcopy.
Having a positive HPV result does not mean your partner has had sex with someone else.
You might have HPV even if you have not been sexually active or had a new partner for many years.
If you need a colposcopy
A colposcopy is a simple procedure to look at your cervix.
It's similar to having cervical screening, but it's carried out in hospital.
You might need one if your results show changes to the cells of your cervix.
Try not to worry if you have been referred for a colposcopy.
Any changes to your cells will not get worse while you're waiting for your appointment.