Cervical screening, otherwise known as a smear test (or pap smear in the USA), is a free NHS service for women testing for cervical health and help prevent cervical cancer. It’s available to women aged 25 to 64, and you are invited to screening by letter through the post from which you can book an appointment at your local GP surgery.
Screening takes place every 3 years for those aged 25-49, and every 5 years for those aged 50-64.
Your cervix is the opening to your womb from your vagina, and the test looks for evidence of the human papillomavirus (HPV) which can cause changes to your cells – and potentially turn into cancer if untreated. Early detection of HPV means the cells can be treated before cancer develops, and so testing regularly is highly recommended to safeguard yourself from future illness. You may have heard of HPV before and been vaccinated for it; you usually get vaccinated aged 12 or 13 in school, and this too can help prevent HPV from developing. However, even with the vaccine you are still at risk, so screening is always recommended to keep on top of your health.
HPV can be contracted through any form of sexual contact with men or women. Women, trans men, and non-binary people (assigned female at birth) who still have a cervix should all have cervical screening to help prevent cervical cancer. Males, trans men and non-binary people who have had a total hysterectomy to remove their cervix do not need cervical screening, and if you’re a trans woman or non-binary person assigned male at birth, you also do not need cervical screening as you do not have a cervix.
So, what should you expect at a screening appointment?
Your appointment will usually be with a female nurse or doctor, and you can request a chaperone if you’d like one. Before they begin, they will go through what will happen and invite you to ask any questions. They’ll also ask you general health questions such as when your last period was.
You’ll be asked to undress from the waist down, and to lie on the examination bed with your legs bent, feet together, and knees apart. You will be behind a screen until you are ready for the nurse to enter, and will have a sheet to put over yourself. The door to the room may be locked to prevent anyone from entering.
The nurse will use a speculum (a smooth, tube-shaped tool) to open your vagina and see your cervix. You may find putting your fists under your back will help. She’ll then use a soft brush to take a sample of cells for testing, and will close the speculum before inviting you to get dressed whilst she processes your sample.
The test will take less than 5 minutes in total, and the whole appointment is usually only 10 minutes.
Your results are usually available within 6-10 weeks, but your nurse/ doctor will inform you of the current waiting time. They are usually sent to you in a letter, though some may require you to call your surgery for the result.
If the results were unclear or (or ‘inadequate’) you may be asked to go for screening again in 3 months’ time. This does not mean anything is wrong, it’s just that they couldn’t read your results properly from the first sample taken.
If no HPV is found, this means your risk of cervical cancer is very low. You do not need any further testing and will be invited for screening again in 3-5 years depending on your age.
If HPV is found, this does not mean you have cervical cancer. Your results letter will explain what will happen next and it’s likely you’ll be invited for further tests. If HPV is found but no abnormal cell changes have taken place, you’ll be invited to another screening in a year’s time; if HPV is found and you have some abnormal cell changes, you’ll be asked to have a colposcopy – a simple procedure to take a more in-depth look at your cervix.