Cervical Screening

Cervical screening (previously called a “smear test or Pap test”) is a simple test to check the health of your cervix (the entrance to the womb). It helps prevent cervical cancer by detecting early cell changes, often caused by human papillomavirus (HPV).

• It is not a test for cancer – it aims to stop cancer developing.
• Free on the NHS for eligible individuals.

Who Should Attend?

• Ages 25–64 (invited automatically via your GP):
  • 25–49: Screened every 3 years.
  • 50–64: Screened every 5 years.
• Trans men/non-binary people with a cervix are also eligible.
• You can still have screening if you:
  • Are not sexually active.
  • Have had the HPV vaccine.
  • Have gone through menopause.

Why is it Important?

• Cervical cancer is one of the most preventable cancers.
• Early detection of abnormal cells allows treatment before cancer develops.
• HPV causes 99% of cervical cancers, and screening identifies high-risk HPV or cell changes.

Preparing for Your Test

• Book when you’re not menstruating (ideally mid-cycle).
• Avoid vaginal creams, lubricants, or sex for 24 hours before the test.

During the Test

1. You lie on a couch – a nurse/doctor gently inserts a speculum (smooth plastic tube) into your vagina to see the cervix.
2. A soft brush collects a small sample of cells (takes 2–5 minutes).
3. You may feel pressure or mild discomfort, but it should not be painful.

Possible Results

Your sample is tested for high-risk HPV first. Results take 2–4 weeks:

1. HPV not found (negative):
   1. Low risk → Next routine screening in 3–5 years.
2. HPV found (positive):
   1. The same sample is checked for cell changes:
      1. No cell changes: Repeat screening in 1 year.
      1. Abnormal cells: Referred for colposcopy (closer examination).

Benefits

• Saves lives – regular screening prevents 75% of cervical cancers.
• Quick, free, and performed by trained professionals.
• Detects issues early, when treatment is simpler and more effective.

Risks/Limitations

• Mild discomfort during or after the test.
• Light bleeding/spotting (common and harmless).
• Anxiety while waiting for results.
• False negatives/positives (rare).

Follow-Up

• Colposcopy: If referred, this 15–20 minute procedure uses a microscope to examine the cervix. A biopsy may be taken.
• Treatment: If needed, minor procedures (e.g., LLETZ – loop excision) remove abnormal cells under local anaesthetic.

HPV Vaccination

• The HPV vaccine (given in school at age 11–13) protects against high-risk HPV types.
• HPV vaccination for adults – You may consider to protect yourself from other high risk HPV virus types. You must continue with screening.

Frequently Asked Questions

Q: Does screening hurt?
A: Most feel mild discomfort, not pain. Tell your nurse if you’re uncomfortable.

Q: I’m embarrassed – what if my vulva looks “abnormal”?
A: Nurses are non-judgmental and see many vulvas daily. Your comfort is their priority.

Q: Can I delay screening?
A: Yes, but delaying increases cancer risk. Discuss concerns with your GP.

Q: What if I’ve never had sex?
A: Screening is still recommended, as HPV can spread through skin-to-skin contact.

eGynaecologist Advice:

• Cervical cancer screening is your choice, but it’s the best way to protect yourself from developing cervical cancer in future. You must talk to you GP or gynaecologist if you have missed a screening test.
• If you have been found to have HPV infection or cell changes on cervical screening you must remain complaint with further follow up appointments as this may offer you a best chance to protect yourself from getting cervical cancer in future.