Why getting a smear test could save your life

Don't put it off. A smear test – now known as a cervical screening – is one of the best ways to avoid developing cervical cancer. 

Why is a smear test so important?

A smear test checks the health of your cervix (the opening to your womb from your vagina).

It's not a test to see whether you have cancer. Rather, it's a test to see if you have cells that could potentially become cancerous. If you do have any of these abnormal cells, they can be monitored or treated so that they don't turn into cancer. Going for regular screenings increases the chance that these cells will be caught early enough, never becoming cancerous.

How often should I attend a smear test?

How often you have a routine smear test depends on where you live in the UK. Maintaining the correct smear test frequency is important, because smear tests can help you detect cancerous cells.

In England

Cervical screening is routinely offered to anyone with a cervix in England between the ages of 25 and 49 every three years. If you are aged 50 to 64 years, you will be offered a routine smear test every five years.

In Scotland

Cervical screening is routinely offered to anyone with a cervix in Scotland between the ages of 25 and 64 every five years.

In Northern Ireland

In Northern Ireland, all women aged 25-49 are invited to attend for a cervical screening test every three years. Women aged 50-64 are invited every five years.

In Wales

Cervical screening is routinely offered to anyone with a cervix in Wales between the ages of 24 and 64 every five years.

If you fall outside these age categories, or would like more regular screening, you can do so privately.

Cervical Screening Awareness Week runs from 13-19 June and is a UK-wide initiative led by Jo's Cervical Cancer Trust. Its aim is to highlight the importance of cervical screening – spreading the message that attending your screening invitation can help prevent against cervical cancer and protect your fertility. If you want to get involved in raising awareness, fundraising or campaigning for Cervical Screening Awareness Week, you can find out how here.

Before your smear test: things to remember

• Wear something you can keep on during the test such as long jumper, shirt or skirt
• Take your friend or relative with you, if you would prefer some emotional support
• Try breathing exercises that can calm and reassure you – your nurse can provide you with examples
• Ask your nurse to use as smaller speculum to prevent any discomfort, if you would like
• Talk to your nurse about more comfortable positions such as lying on your side
• Bring your earphones or airpods along to listen to music or a book to read during the test

The don'ts of smear tests

• Don't apply any vaginal creams, medications, or lubricants in the two days before your test as these can affect your results
• Don't book a smear test appointment on a day you expect to have your periods – if you do not have periods you can be screened at any time
• Don't force yourself to keep going during the smear test. If you uncomfortable at any point, you can ask to stop the test
• Don't be scared or embarrassed to talk to the nurse. It's important for them to know how you're feeling during your test

How does a smear test work?

For most people, the smear test can be a bit uncomfortable, but not painful. The procedure for a smear test typically takes about five minutes and the appointment itself lasts around 10 minutes. When you enter your appointment, you will be required to undress behind a screen from the hips down. Your nurse or GP will also place a sheet over you. Afterwards, your nurse will request you to lie back with your knees bent, and both your feet and knees apart. You can talk to your nurse about changing your position to feel more comfortable before or during the test.

Your nurse will then gently put a smooth, tube-like tool otherwise known as a speculum into your vagina. A small amount of lubricant may be used, depending on if you've requested a smaller speculum. The nurse will then open the speculum for them to see your cervix — and with a soft brush a small sample of cells will be taken from your cervix. Finally, the nurse will close and remove the speculum. They will then leave you to get dressed. It is common to experience some spotting or light bleeding after your smear test.

Why do people avoid having a smear test?

There is no one reason why people fail to attend cervical screenings. There are common reasons why people do not attend screenings:

1. People are embarrassed to have a smear test

Don't let anxiety about your body shape or genitals stop you from attending your smear test. It may seem awkward to you, but the person performing the test is a professional who deals with these things every day. There is no reason to feel nervous. Talk to your nurse about any concerns or awkwardness you might have. They are there to make you feel comfortable.

2. People don't fully understand the purpose or importance of a smear test

If there was a test that could help prevent cancer, wouldn't you take it?

How long do smear test results take?

After your smear test, your sample will be sent to a laboratory and tested for the types of HPV that can cause cervical cancer. Your results may be posted to you or you may be asked to collect your results. Sometimes test results can be unclear and you may need to revisit your GP or clinic to have your test repeated. This is referred to as an inadequate test result.

What does your smear test result mean?

There are more than 100 types of HPV. But at least 14 types of HPV are labelled as high-risk and can cause cancer. HPV is contracted through skin-to-skin contact during any form of sexual activity between a man or a woman. It can remain in the body for several years at low or undetectable levels without causing problems. However, in some cases HPV can cause the cells in the cervix to become abnormal.

HPV negative result

If the human papillomavirus (HPV) is not found in your sample, you have an HPV negative result. An HPV negative result mean it is highly unlikely that you have abnormal cervical cells. But your GP may request you to come back for another screening in 3 to 5 years' time.

If the human papillomavirus (HPV) is found in your sample, it will be tested again for any abnormal cervical cells. If no abnormal cells are found, your test result will state that you are HPV positive but with no abnormal cells. You will be invited for a second screening and the details of these will be shared in your results letter. The second screening is important to check if your immune system has removed the HPV infection from your body.

If the human papillomavirus (HPV) is found your sample and it shows you have abnormal cells, you will be referred to colposcopy. A colposcopy is a procedure used to examine the cervix (this is your opening to your womb). The GP may also refer you to a colposcopy if your test results are unclear after several screening tests or if they thought your cervix does not look as healthy as it should be.

The nurse or GP will insert a speculum to open your vagina and on liquids will be applied to highlight any abnormal parts of your cervix. A small sample of tissue may be collected for further examination and you may experience some discomfort. It can take between four to eight weeks to receive your biopsy result.

Treatments for abnormal cervix cells

If the colposcopy reveals you have abnormal cells, you will need treatment to remove them. If you have abnormal cells in your cervix, your colposcopy will show a number. This number refers to the chances of the cells becoming cancerous if they are not removed. The most common treatment used for abnormal cervical cells is a large loop excision of the transformation zone (LLETZ) also known as a loop diathermy excision.

During this procedure, a small wire loop is used to remove the abnormal cells in the cervix. A local anaesthetic is injected into the area to prevent pain. After the surgery, you may experience some pain, or bleeding or discharge, which is similar to a heavy period. It is recommended that you abstain from sexual intercourse and use sanitary pads instead of tampons for four weeks after the procedure to lower your risk of bleeding or developing an infection. It is important to avoid vigorous exercise and that includes swimming for at least two weeks.

At Circle Health Group, we have a dedicated team of specialist gynaecologists, who can guide you through your smear test and provide a colposcopy to check the overall health of your cervix. If a smear test or colposcopy reveals you have any abnormal cells, our consultant gynaecologists can provide accelerated access to treatments such as loop diathermy excision or LLETZ treatment.

If you would like to book your smear test at a hospital near you, you can book online or call our team.