Cervical Screening: The facts
For many women the thought of going for cervical screening is often worse than the reality. Do not worry if you feel anxious about having your screening test, this is normal and many women feel like this. It can help to be as informed as possible about what having a cervical screening is like. Make sure you discuss any concerns with your practice nurse.
- Each year around five million women in the UK are invited for cervical screening (smear test)
- Cervical screening saves 5,000 lives a year in the UK
- Cervical screening is free and you should receive your invitation to attend for regular screening (it is important that you let your GP practice know of any change in your name or address)
- If you are feeling anxious beforehand, you can ask a member of your family or friend to accompany you. Your practice nurse or GP will be happy to talk through any anxieties that you have prior to your cervical screening appointment
- Cervical screening is NOT a test to find cancer. It is a screening test to detect changes to the cells of the cervix, which are called cervical abnormalities or pre-cancer
- Between 90 and 94% of all screening results come back normal, with no abnormalities found
- It is important to remember that an abnormal screening result rarely means cancer
- Having regular cervical screening offers the best protection against developing cervical cancer
- Please take up your invitation to attend your cervical screening test; regular screening saves lives
What will happen during the cervical screening (smear test)?
Your cervical screening appointment should take no longer than around 10 minutes, with the procedure itself taking approximately three minutes. If it is the first time you are attending your screening it can be helpful to find out as much as possible about what will happen beforehand.
You can bring a relative or friend with you if you need support and you can request a female practice nurse to take the sample if that makes you feel more comfortable. Before the procedure starts the practice nurse should explain what is going to happen and answer any questions or concerns you may have.
You will be asked to undress from the waist down (if you are wearing a skirt you can leave this on and just remove your underwear) and to lie on an examination bed on your back. A paper sheet will be placed over the lower half of your body. Your practice nurse will then insert an instrument called a speculum into your vagina. A specially designed brush is used to take a sample of cells from your cervix. The sampled cells are immersed in a vial of liquid to help preserve them and are then looked at under a microscope in a laboratory.
For most women cervical screening is not painful, but it may feel a little uncomfortable. Therefore, if you experience any pain or other problems please do let the doctor or nurse know.
The best time (if possible) for a cervical screening to be taken is in the middle of your menstrual cycle, halfway between one period and the next. This enables the cytologist to examine the best possible specimen and achieve the best possible report. Most GP surgeries will ask you to book the test yourself, so remember to take your menstrual cycle into account before you book your screening test.
Receiving your results
Once your cervical screening sample has been taken it will be reviewed by specialists at a lab. You should receive the results of your screening within six weeks.
If there are no abnormalities seen (the test is 'negative' and everything is fine) you will be sent a letter confirming the result.. Sometimes the hospital may contact you with the result.
A negative results means you will be recalled for screening in three or five years time, dependent on your age. If the specialist looking at your cervical screening test feels it would be advisable for you to be reviewed by a hospital doctor then they will inform your practice nurse or GP. In some areas there is an agreement between the hospital and the GP's surgeries that women are informed by letters directly from the hospital, and an appointment is made and enclosed in the same mailing.
More than nine out of ten screening results are negative and around one in 20 show low grade changes. For most women with low grade changes, the cells will go back to normal without treatment.
One in a 100 test results show moderate changes (dyskaryosis) and one in 200 show high grade dyskaryosis. If your results indicate that you have dyskaryosis, you will be sent for colposcopy to investigate it further.
It is extremely rare for cancer to be diagnosed from a cervical screening test. Less than one in 1,000 women's test results show invasive cancer.
Is there anyone who may not need to go for cervical screening?
A small minority of women may not need a cervical screening.
Women who have never been sexually active:
- The incidence of cervical cancer is extremely rare in women who have never been sexually active and the guidelines issued suggest that women who are sexually active attend for screening at the age of 25. More than 99% of cervical cancers are linked to infection with sexually transmitted high risk HPV so it is recommended that if you have ever had sexual intercourse or genital-to-genital contact with a man or a woman, even just once, then you should attend for regular cervical screenings.
- If you are not currently in a sexual relationship but have been in the past, you are recommended to have regular cervical screening.
Women over 65:
- Women aged 65 and over who have had three normal test results in a row are not called back for further cervical screening tests. It is very unlikely that women in this category will go on to develop cervical cancer.
- If you are over 64 and have had abnormal results you will continue to be invited for screening until the cells return to normal. Women aged 65 and over who have never had screening are entitled to a test.
- If you have never had a screening test and have been sexually active, you should have a test, regardless of your age.
Certain groups of women who have had hysterectomies:
- Some women who have had a hysterectomy are still thought to be at risk of developing abnormal cells and so should continue to have regular cervical screenings. For example, if your womb was removed but you still have your cervix, you should continue to go for regular screening.
- If your womb and cervix were removed to prevent or treat cancer, you may still be asked to have a vaginal smear (vault smear) for a short period of follow-up. If your womb and cervix were removed for a benign (non-cancerous) condition, such as fibroids or heavy bleeding, you do not need to have any more cervical screenings. In general, if you do not have a cervix then you do not need to attend a cervical screening.