London, UK: The NHS advises women between the ages of 25-49 to have a cervical smear test every three years, but many avoid doing so because of fear or embarrassment.
The test checks the health of cells in the cervix. Detecting abnormal cells early, and having appropriate treatment, can help prevent cervical cancer.
Women aged 50-64 are advised to have the test every five years.
Chloe Delevingne had a smear test live on the Victoria Derbyshire programme, to help raise awareness.
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 v****a.
Detecting and removing abnormal cervical cells can prevent cervical cancer.
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.
It’s possible for sexually active women of all ages to develop cervical cancer, although the condition is most common in women aged 30 to 45. The condition is very rare in women under 25.
The cervical screening programme
The aim of the NHS Cervical Screening Programme is to reduce the number of women who develop cervical cancer and reduce the number who die from it.
Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7% each year.
All women who are registered with a GP are invited for cervical screening:
- aged 25 to 49 – every 3 years
- aged 50 to 64 – every 5 years
- over 65 – only women who have recently had abnormal tests
Trans men who still have a cervix and are still registered as female with a GP will also be invited for cervical screening. Trans men who are registered as male will need to let a GP or Practice Nurse know so they can organise the test.
Women over 65 who have never been for cervical screening can have the test. Ask a GP or Practice Nurse for more information.
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.
Cervical screening isn’t 100% accurate and doesn’t prevent all cases of cervical cancer, but it’s the best way to pick up any abnormal cells that could later turn into cancer.
Screening is a personal choice and you have the right to choose not to attend.
What happens when you go for cervical screening?
Booking your test
You’ll receive a letter through the post asking you to make an appointment for a cervical screening test. The letter should contain the details of the place you need to contact for the appointment.
Screening is usually carried out by the practice nurse at your GP clinic. You can ask to have a female doctor or nurse.
If possible, try to book an appointment during the middle of your menstrual cycle (usually 14 days from the start of your last period), as this can ensure a better sample of cells is taken.
It’s best to make your appointment for when you don’t have your period.
If you use a spermicide, a barrier method of contraception, or a lubricant jelly you shouldn’t use these for 24 hours before the test, as the chemicals they contain may affect the test.
Your screening appointment
The cervical screening test usually takes around 5 minutes to carry out.
You’ll be asked to undress from the waist down and lie on a couch. If you’re wearing a loose skirt you can usually remain fully dressed and just remove your underwear.
The doctor or nurse will gently put an instrument called a speculum into your v****a. This holds the walls of the v****a open so the cervix can be seen.
A small soft brush will be used to gently collect some cells from the surface of your cervix.
Some women find the procedure a bit uncomfortable or embarrassing, but for most women it isn’t painful.
If you find the test painful, tell the doctor or nurse as they may be able to reduce your discomfort.
Try to relax as much as possible as being tense makes the test more difficult to carry out. Taking slow, deep breaths might help. You can also bring someone along to the appointment with you if you want support.
The cell sample is then sent off to a laboratory for analysis and you should receive the result within 2 weeks.
Changes in the cells of the cervix are nearly always caused by the human papilloma virus (HPV).
There are more than 100 different types of HPV. Some are high-risk types linked to cervical cancer, and some are low-risk types linked to other conditions, like genital warts. Most cervical cancers are caused by high-risk types HPV-16 and HPV-18.
After successful trials, HPV testing has been added into the NHS Cervical Screening Programme.
If a sample taken during the cervical screening test shows low-grade or borderline cell abnormalities, the sample should automatically be tested for HPV.
If HPV is found in your sample, you should be referred for a colposcopy for further investigation and, if necessary, treatment.
If no HPV is found, you’ll carry on being routinely screened as normal. If your sample shows more significant cell changes, you’ll be referred for colposcopy without HPV testing.
In some areas, a test for HPV is the first test on the screening sample. This is called primary HPV screening. In these cases, the sample is only checked for abnormal cells if HPV is found.
If HPV isn’t found, you’ll be offered a screening test again in 3 to 5 years (depending on your age).
In 2019, primary HPV screening will become the routine way of testing cervical screening samples across the whole of the Cervical Screening Programme