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What is a cervical screening?

A cervical screening (also known as a smear test) is used to detect abnormal cells on the cervix before they become cancerous cells. The screening programme in the UK suggests a smear test every 3 years for women aged 25-49 every 5 years for women aged 50-64. 

All girls at the age of 12 are also recommended immunisation against human papilloma virus (HPV) with the virus being known to cause most cases of cervical cancer. Indeed, a recent publication in the Lancet showed that HPV immunisation has successfully almost eliminated cervical cancer.

What might the results of my cervical screening show?

Currently when you have a smear test, they only look for the presence of human papilloma virus and do not look specifically at the cells unless HPV is present. Those results can come back as either showing no abnormal cells, mild abnormalities, moderate abnormalities or maybe severe abnormalities, with the whole idea being to catch the changes in the cells when they are mild to prevent them from becoming cancerous. If abnormal cells are found in the presence of high-risk HPV, you will be advised that you need something called a colposcopy which essentially takes a closer look at the cervix with a view to identifying the abnormal cells and removing them.

What can I expect to happen during my smear test?

A smear test is a quick and easy procedure and whilst it may be a little embarrassing, there is clear proof that it will prevent cervical cancer. It may feel quite invasive, as an instrument is introduced into the vagina to expose the cervix and a small brush is used to remove some cells from the cervix. It is, however, super quick and should not be particularly uncomfortable. Ask the person doing the test to use a small speculum if possible!

Why should I have a smear test?

The big question really is not why ‘would you attend for a smear test?’ but ‘why would you not attend for a smear test?’. Even if you have had your HPV immunisation, it is still important to have a smear test.

Smear tests are available as part of the NHS screening programme and are also obtainable by private GPs or private gynaecologists and there is lots of information via the Internet on how a smear test is performed and what the results may show. We are extremely fortunate in the UK to have this service that is so effective in preventing cancer.

Top tips from a gynaecologist if you’re feeling anxious about attending your cervical screening:

  1. If you’d feel more comfortable with a female performing your smear test, then do ask for this beforehand, especially if it would make you feel less anxious. 
  2. You can always ask the person performing the screening to stop at any point if you feel uncomfortable. Remember you are in control of the situation.
  3. Remember that the person performing the procedure will have seen lots of vaginas and vulvas in their time. There is no need to worry about what yours looks like, or do anything ‘special’ to it beforehand.
  4. Do share any of your anxieties or concerns with the person performing the smear test beforehand.
  5. Empty your bladder before the test, as a full bladder will make the procedure more uncomfortable.
  6. Do ask for a small speculum. Speculums come in different sizes, and a smaller one can make the procedure feel less uncomfortable.  
  7. To reduce any discomfort, the person performing the test can add lots of lubrication too. 
  8. Wear something suitable for the test. Wearing an all in one outfit would mean that your upper body would be exposed as well! Wearing a skirt can offer you some extra cover which may make you feel less exposed.
  9. Remember the procedure is very quick and takes less than 5 minutes
  10. Focus on the fact that you are doing something really good that may save your life.