8 essential things you should know about smear tests

If it’s been a while since your last cervical screening, you’re not alone.

In the last year, UK research shows around 360,000 women weren’t tested for cervical cancer – a 5.3% decrease from 2023.

However, smear tests are just as crucial as ever, with 99.8% of cervical cancer cases being preventable.

Thanks to scientific advances, medical professionals can pinpoint who is most at risk of cervical cancer by using HPV primary screening, which help patients feel more confident that any worrying signs can be picked up early.

So, what happens during a cervical screening and why is it important? In light on HPV Awareness Day, we share eight essential things to know about a smear test.

Testing is more accurate than ever

Previously, after a smear test, samples were sent off to be analysed for changes in the cells and to detect any abnormalities.

Now, however, the screening process tests specifically for the human papillomavirus (HPV), which is more accurate and better at detecting cell changes, as well as detecting it earlier, all of which is good news for cancer prevention.

Particularly when 99% of all cervical cancers are linked to these high-risk strains of HPV.

Should you test positive for high-risk HPV, you will be informed and your cells will then be analysed to look for any abnormalities. At this point, remind yourself to stay calm and not to worry as there are proceeding steps to go through and the doctors will ensure you receive the right pathway of treatment.

“It may feel strange or uncomfortable but it should not cause you pain”

Dr Rosie Godeseth, Vitality's Medical Director of Health          

Following that, you’ll be referred for a colposcopy, a gentle procedure where cells are inspected with a microscope.

If the result of your colposcopy is normal, you won’t need any immediate treatment and will return to routine screening programmes.

If not, any abnormal cells will need to be removed.

Tests are every three to five years depending on risk and age

Firstly, cervical screenings are free for anyone with a cervix between the ages of 25 and 64. In order to be referred for screening you will need to be registered as female with your GP.

Because the test detects people at higher risk of developing cervical cancer more accurately, the intervals between screening tests can be safely extended for people who are not high-risk.

So, what does this mean? For those aged between 25 and 49 you will get an invite from the NHS every three years.

After that, you will receive an invitation every five years until the age of 64. For more information, visit Cancer Research UK.

When your appointment is due, you’ll be sent an invitation letter in the post telling you how to book and where you can go – it’s usually at your GP surgery or a local sexual health clinic.

If you would like to know more on understanding women's health and your policy options visit here: Understanding Women's Health | Key Health Checks and Tests

The screening should not hurt

The screening involves a healthcare professional, such as a nurse or doctor, taking a small sample of cells from the wall of the cervix and lasts for around five minutes.

“It may feel strange or uncomfortable, but it should not cause you pain,” says Dr Rosie Godeseth, Vitality’s Medical Director of Health.

“If you’re feeling nervous or have had painful experiences in the past, it’s important to communicate this,” adds Godeseth.

“The nurse or doctor can take steps to make the procedure as comfortable as possible, such as using a smaller speculum or suggesting different positions.”

Here’s what to expect:

• You will be asked to remove your clothes from the waist down, including your underwear but will be given a paper sheet to cover your hip area. Or you can wear loose-fitting skirt or dress if you prefer and just lift it up.
• Put the soles of your feet together and allow your knees to drop open to the sides, then the nurse will gently slide a plastic speculum into your vagina to see the cervix clearly.
• They will then use a soft brush to take some samples of cells from the surface of your cervix, which is put into a small container of liquid to send to the lab.
• They’ll then gently take out the speculum and the test is over. You should get your results in two to six weeks.

You can make it more comfortable

It’s totally normal to be nervous about going to do a smear test. Happily, there are things that you can do to help make the process easier.

1. Tell the medical professional if you’re worried or have had a bad experience before
2. You can bring a friend, partner or family member with you for support
3. Ask for a female nurse to carry out the procedure
4. Consider doing some breathing exercises if you feel yourself tensing up – ask to pause as you take some breaths and relax. Remember, you can stop at any time.

It’s common to experience some light bleeding, spotting or cramping after having a smear test.

If these don’t improve after a few hours, or the symptoms are severe, contact your GP.

The HPV vaccine doesn’t mean you don’t need a smear test

The HPV vaccine is a huge success – a 2021 study found a 97% drop in pre-cancerous changes to cells in girls vaccinated between the ages of 12 and 13, and it has cut cases of cervical cancer by nearly 90% – but there is still a need to attend screenings.

“The HPV vaccine protects against the most common high-risk types of HPV, but it doesn’t cover all types that can cause cervical cancer,” says Godeseth.

“It’s still important for anyone with a cervix to get screened”

Dr Rosie Godeseth, Vitality's Medical Director of Health

“Additionally, the vaccine doesn’t treat existing HPV infections, so if you were exposed to the virus before getting vaccinated, you could still be at risk.”

It’s still important to get screened whether you have sex or not

“While HPV, a main cause of cervical cancer, is often transmitted through sexual contact, it’s still important for anyone with a cervix to get screened,” explains Godeseth.

HPV can spread through any kind of skin-to-skin contact around the genital or oral area.

So, even if you haven’t had penetrative sex, you could still be at risk.

Cervical screening is crucial for prevention

Cervical cancer is the fourth most common cancer in women globally, yet it is highly preventable with regular screening.

Yet, around one in three people with a cervix do not attend when invited, and there are a number of reasons for this.

This can be anything from busy schedules to previous trauma and feelings of fear or embarrassment.

It can be hard for many reasons, but screening is a vital part of identifying if you are at higher risk of developing cervical cancer, allowing for further monitoring or treatment.

This proactive approach saves thousands of lives every year.

Cervical cancer symptoms to be aware of

Some people who are diagnosed with cervical cancer have no symptoms, which is why it’s so crucial to attend your cervical screening when called, but it’s also worth being aware of the most common signs:

• Unusual vaginal bleeding
• Pain or discomfort during sex
• Abnormal bleeding, such as bleeding between periods
• Vaginal discharge that smells unpleasant
• Pain in the pelvis area.

Most of the time these symptoms will be caused by something else, but you should never ignore them and reach out to your GP to get them checked.

Related: Kirsten’s cervical cancer survivor story