Whether you’ve just been called up or you’re looking ahead to your next cervical screening (cervical smear) appointment, it’s more important than ever not to miss this routine test.
There were an estimated 33,000 cases of cervical cancer in Europe in 2018, with 15,000 people dying from the disease. The average age at diagnosis globally is 53, yet it’s the third most common type of cancer affecting people under the age of 45.
‘Each year in the UK alone, around 4,500 lives are saved by cervical screening – which shows the importance of having regular tests,’ says Dr McClymont.
When do I need to go for a cervical screening?
‘Any person with a cervix is invited for screening automatically when they reach the age of 25, and if the results are normal they’ll receive further invites every 3 years until the age of 49,’ Dr McClymont explains.
‘Between the ages of 50 and 64, you’ll be invited every 5 years.’
You won’t usually need to have cervical screening if you’re pregnant – until at least 12 weeks after you’ve given birth. This is because pregnancy can make it harder to get clear results.
What if I’m embarrassed by the thought of a 'smear test'?
Despite the evidence that regular screening is so effective in detecting abnormal cell growth and the virus that causes cervical cell changes, human papillomavirus (HPV), many people avoid the tests due to embarrassment or anxiety.
‘People who avoid cervical screening often say awkwardness is the biggest reason for doing so,’ says Dr McClymont. ‘But it’s a short procedure, and your doctor or nurse has seen it all before – they’re just interested in testing your cervix. This is a simple test that could save your life, and there’s really no reason to be embarrassed.’
What does the cervical screening test for?
‘The test looks for abnormalities in the cells of the cervix, as well as for HPV, which, if present, can cause abnormal cell growth,’ says Dr McClymont.
Has the cervical screening process changed as a result of the pandemic?
As a result of lockdowns, reallocation of staff and the prioritisation of other urgent care, the pandemic has caused significant disruption to cervical smear screening programmes throughout Europe. So, it’s more important than ever to attend your cervical screening when you’re called.
The test itself hasn’t changed as a result of the pandemic, says Dr McClymont, but you might find that processes at your local GP surgery have changed. ‘The nurse will wear a mask, and there may be fewer appointment slots available as it takes longer to thoroughly clean a clinical room between patients.’
How can I prepare for a cervical screening if I’m anxious or nervous?
It’s not unusual to be anxious before a cervical screening. Some people find that asking for a female nurse or doctor helps them feel more at ease, and relaxation breathing can help too. You can also ask the person performing the test to start with the smallest speculum.
‘If you’re nervous about undressing, wearing a loose skirt is a good idea as you won’t need to fully remove it for the procedure,’ says Dr McClymont.
What should I expect during the test itself?
The nurse performing the cervical screening will explain to you exactly what will happen when you arrive and answer any questions you have before the test.
- You’ll be invited to lay on an examination couch behind a screen and remove clothing from your lower half
- There will be a sheet or piece of clinical roll for you to cover your groin with, and you’re entitled to have a chaperone in the room with you if you’d prefer
- You should lie on your back with your feet together and knees apart
- The nurse will insert a lubricated plastic speculum into your vagina to enable good visualisation of your cervix
- A small 'brush' is then used to remove some cells from the cervix, which are deposited in a small pot and sent to the laboratory for analysis
The examination itself usually only takes a few minutes.
Can it ever be painful or uncomfortable?
‘A cervical screening is usually not a painful procedure, although some people report mild discomfort,’ says Dr McClymont, adding that it’s usually worse if you’re tense or anxious, as your pelvic floor muscles are more likely to tighten, making the procedure more difficult.
‘If you’re very anxious, take some deep breaths and try to relax as much as possible.’
Is it normal to bleed after the screening?
‘A small amount of spotting after the procedure is quite common, but it should resolve very quickly,’ says Dr McClymont. ‘Wearing a pantyliner for a few hours is normally all that’s required.’
What happens after the screening?
After the test, the specimen is sent to a laboratory for analysis. It usually takes around 2 weeks for the results to come back.
‘If your results are normal, no further action is required, and you’ll be invited for another routine smear 3 or 5 years later, depending on your age,’ says Dr McClymont. ‘If abnormalities are found, however, you’ll usually be invited for a procedure called a colposcopy, to look at your cells in more detail.’
A colposcopy, Dr McClymont explains, is a procedure similar to a cervical smear, but it’s performed in hospital using a microscope and special dye to stain the cervix cells and make abnormalities easier to identify. ‘Having abnormalities in your cells usually doesn’t mean that you have cancer, but further tests or treatment are recommended to prevent cancer developing in future.’
Do you need to have a cervical screening if you’re not sexually active?
People who have never been sexually active have a very low risk of cervical cell abnormalities – but not a zero risk. That’s why attending a screening is always advisable, regardless of your sexual history. ‘If you’ve never had sex, this may understandably make you nervous,’ says Dr McClymont. ‘It’s best to chat to a doctor or nurse about your individual circumstances.’