Cervical screening (smear test) is a screening test that is free and available on the NHS as part of the National Cervical Screening Programme. Women are automatically invited by letter, between the ages of 25 – 64 and if registered as a female with a GP surgery. Anyone with a cervix can have cervical screening.
Women between 25-49 years of age are invited 3 yearly and 5 yearly 50-64 years of age. Women are usually invited up to 6 months before their 25 birthday and you can call your GP surgery as soon as you receive your letter to arrange your appointment with the nurse who will carry out the test. It is better not to book your smear test when you are having a period as it is not as easy to obtain a result. Sexual health clinics carry out smear tests as well as GP surgery’s. It is an important screening test and appointments can fit in with you and your work commitments as much as possible to enable you to attend.
Many people don’t find the test uncomfortable but some may find it more uncomfortable and occasionally may hurt them. There can be many psychological and or physical reason for this. Talk to your nurse about any anxieties you may have regarding the test and she/he will ensure you have any support needed. If you wear something long/dress/skirt/long shirt then you would not need to undress fully and may feel more comfortable. The nurses who perform the test are experienced in cervical screening and will be supportive and understanding. You will be asked to undress from the waist down whilst behind a curtain and given some privacy to do so. If you would like to have someone with you for support then please ask your nurse. A plastic/disposable and smooth instrument called a Speculum is passed into the vagina. As it is opened it enables to cervix to be visualised. The test involves a small soft brush that takes a sample of cells from the cervix and should take less than 5 minutes, with the appointment taking no longer than 10 minutes.
Cervical screening is not a test for cancer. You can protect yourself from cervical cancer by having the test as it checks the health of your cervix and looks for abnormal changes in the cervical cells that could become cancer if left untreated. The cervical smear test also looks for high risk HPV infection (Human papillomarvirus). If you have a cervix and have any kind of sexual contact you could get cervical cancer, therefore the screening is so important to attend when you are invited. If you miss an appointment or there is a gap between receiving your letter inviting you to book a smear test, you can still contact the GP surgery to arrange.
HPV (Human papillomavirus) is a type of virus that is common and lives on the skin and can affect mucosa (moist membranes) such as the cervix. Most people will get some type of HPV during their lives and most people’s bodies (immune systems) will fight it off and it will go without causing any problems. Some types of HPV can affect the genital areas and some types of HPV are linked to abnormal cell changes within the cervix that can be detected before they develop into cervical cancer.
It you have a cervix and have any form of sexual contact (does not have to be penetrative) you are at risk of HPV.
From September 2019, the HPV vaccine is offered free to both girls and boys between the age 12-13. You cannot have the vaccine if you are pregnant.
The risk of developing cervical cancer under the age of 25 years old or over the age of 64 (if you have had regular cervical screening) is rare. If you have bleeding inbetween your periods, during or after sex or after the menopause you should see your GP.
During pregnancy
Smear tests are not usually performed during pregnancy and it is advised to leave until 3 months after pregnancy if your smear test was due during your pregnancy. It should be delayed if you are less than 12 weeks following a miscarriage, or termination of pregnancy. It can be harder to obtain a clear result during pregnancy. If you’ve had a previously abnormal result and been called for repeat smear, you should have this done during pregnancy, ideally between 3-6 months (RCOG 2013). The test will not affect the pregnancy. The Royal College of Obstetricians and Gynaecologists (RCOG) have published a patient information leaflet that can be found via this link: Cervical smears and pregnancy patient information leaflet (rcog.org.uk)
If you have had an abnormal result whilst pregnant you may not require treatment but you may be advised to have a repeat smear in 1 year to ensure the cells have returned to normal or some women may be advised to have a colposcopy. The colposcopy involves having a closer look at the cervix and is safe during pregnancy. You would need to inform your specialist if you are pregnant and in-between appointments or follow up and fall pregnant.
For further information regarding cervical screening, what it involves, what results may mean and for further support please refer to: About us | Jo’s Cervical Cancer Trust (jostrust.org.uk) or Cervical screening – NHS
Deb Hamilton-Rose