A smear test lasts 5 minutes, the impact of cervical cancer can last a lifetime !

A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina.

Detecting and removing abnormal cervical cells can prevent cervical cancer.  This page should tell you everything you need to know about cervical screening.

Testing for abnormal cells

Cervical screening isn’t a test for cancer, it’s a test to check the health of the cells of the cervix.  Most women’s test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix.  Most of these changes won’t lead to cervical cancer and the cells may go back to normal on their own.  But in some cases, the abnormal cells need to be removed so they can’t become cancerous.

About 3,000 cases of cervical cancer are diagnosed each year in the UK.

The cervical screening programme and when it’s offered

The aim of the NHS Cervical Screening Programme is to reduce the number of women who develop cervical cancer and the number of women who die from the condition.  Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7% each year.

Women aged 25 to 64 who are registered with a GP are automatically invited for cervical screening.

This includes women who have had the HPV vaccination, as the vaccine doesn’t guarantee complete protection against cervical cancer.

  • aged 25 to 49 – every 3 years
  • aged 50 to 64 – every 5 years
  • over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests

Being screened regularly means any abnormal changes in the cells of the cervix can be identified at an early stage and, if necessary, treated to stop cancer developing.

When a screening test may not be recommended

In some cases, you may not need cervical screening or it may be recommended that you delay having a screening test.

These situations are described below.

Women with symptoms of cervical cancer

Cervical cancer screening is not a test for symptoms of cervical cancer.  You should see your GP if you have symptoms, such as:

  • unusual bleeding
  • pain and discomfort during sex
  • unusual vaginal discharge

If necessary, your GP can refer you to a gynaecologist.

Women who haven’t had sex

The risk of cervical cancer is very low in women who have never had sex. As the risk is so low, women in this group may choose not to have cervical screening when invited ( please inform your GP surgery).  But if you’re not currently in a sexual relationship but have been in the past, it’s recommended that you have regular cervical screening.

Pregnant women

Cervical screening tests aren’t usually recommended while you’re pregnant, unless you’ve missed previous screening appointments or you’ve had abnormal results in the past.

If you’re pregnant and have always attended your screening appointments without having abnormal results, it’s usually recommended that you wait until 3 months after giving birth before having a screening test. If you’re invited to cervical screening while pregnant and you’re unsure whether you need to be tested, contact your GP or practice nurse for advice.

Women aged 65 and over

Women aged 65 and over whose last 3 test results were normal aren’t invited for further cervical screening tests. This is because it’s very unlikely that women in this group will go on to develop cervical cancer.

If you’re over 64 and have had abnormal test results, you’ll 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.

Women who have had a total hysterectomy

Women who have had a total hysterectomy (an operation to remove the womb and cervix) will no longer be invited to attend cervical screening, as it’s not necessary. Women who have had a hysterectomy that has left all or part of the cervix in place will be invited for screening once their postoperative care has finished.

Women who have had a total hysterectomy to treat cancer, or who had cervical intra-epithelial neoplasia (CIN, a type of cervical cell change that can lead to cancer) at the time of having a total hysterectomy, may need another type of test called a vault smear.  This is where a sample of cells is taken from the vagina close to where the cervix used to be.  Vault smears are part of the follow-up treatment for hysterectomy and aren’t part of the cervical screening programme.

Why aren’t women under 25 routinely screened?

Women under the age of 25 aren’t routinely invited for screening as part of the NHS Cervical Screening Programme.  This is because normal developmental cell changes in the cervix can look very similar to abnormal cell changes, leading to unnecessary treatment and worry.  Cervical cancer is also very rare in this age group.  If you’re under the age of 25 and worried about your risk of developing cervical cancer, or you’re concerned about other aspects of your sexual health, visit your GP or your local GUM clinic for advice.

Getting symptoms checked

If you’ve recently had a cervical screening test and the results were normal, but you develop symptoms such as unusual vaginal bleeding, visit your GP or GUM clinic for a check-up.  There could be several different reasons for your symptoms, so further investigation is needed.

For further information please click the following links:

Jo’s Cervical Cancer Trust  https://www.jostrust.org.uk/
Women affected by cervical cancer  https://www.jostrust.org.uk/your-stories/women-affected-cervical-cancer
Helping you decide leaflet https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/598278/cervical_screening_leaflet.pdf

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