The Importance of Smear Tests

Published: 17th January, 2022 in: Health

If you have a cervix and are over the age of 25, you will more than likely have had a letter inviting you for a smear test. Whilst they may not be the most comfortable procedure, they are extremely important and could even be life saving.

Public Health England released data in 2019 that showed cervical screening uptake was at a 20 year low. In 2019/20 uptake was around 72.2% (Cancer Research UK). This is around 8% lower than the acceptable threshold denoted on the gov.uk website.

Data also shows that those aged 25-49 are less likely to go for a smear test than those aged 50-64. The current uptake for eligible 25-49 year olds is approximately 70.9%. This figure has risen from 69.4% in recent years but there is still some way to go to reach the 80% acceptable threshold.

Our guide compiles everything you need to know about cervical screening. We aim to answer the most commonly asked questions and help alleviate any worries you may have.

What is a Smear Test?

The purpose of a smear test is to check the health of your cervix. This is the opening to your womb from the vagina.

Smear tests do not check for cancer, they are designed to help prevent cervical cancer.

A sample of cells will be taken from your cervix during your smear test appointment. They will then be checked for certain types of human papillomavirus (HPV). High risk HPV types can cause changes to the cells in your cervix. This can turn into cervical cancer if left untreated.

All women and people with a cervix, aged between 25 and 64 are eligible for a smear test and should be invited by letter to book an appointment.

Why are Smear Tests Important?

Cervical screening is one of the most effective ways to prevent cervical cancer. If HPV is detected early, it can be treated before it turns into cancer.

The Public Health England research estimates that with regular smear tests, 83% of cervical cancer cases could be prevented. Currently, around 2600 people are diagnosed with cervical cancer every year. Of this, approximately 690 people die from it, correlating to around 2 people per day.

What is HPV?

HPV is the name for a common group of viruses passed on via skin to skin contact of the genital area. This can occur during vaginal, oral or anal sex, any skin-to-skin contact of the genital area and by sharing sex toys.

Most people will contract HPV at some point in their lives. It is nothing to be ashamed of and your body will usually get rid of HPV without any complications within 2 years.

In some cases, HPV can stay in the body for longer, however. The smear test checks for high risk types of HPV that can cause changes to the cells in your cervix, resulting in cervical cancer.

If high risk types of HPV are not present, you are very unlikely to develop cervical cancer.

Who is at Risk of Cervical Cancer?

Anyone with a cervix who has had any kind of sexual contact could be at risk of cervical cancer.

You are still at risk of cervical cancer even if:

You have had the HPV vaccine
You have only had 1 sexual partner
You have not been sexually active in a long time or have had the same partner for a long time
You have only had sexual contact with women
You have had a partial hysterectomy that did not remove all of your cervix
You are a trans man with a cervix

It is your choice whether you want to attend a smear test or not however, it is the best way to protect yourself from cervical cancer.

What Happens in a Smear Test?

During your smear test appointment, a small sample of cells will be taken from your cervix. These will be tested for high risk types of HPV.

The appointment should take approximately 10 minutes in total, with the procedure itself taking around 5 minutes. It will be carried out by a qualified doctor or nurse, who will usually be female.

At the beginning of your appointment, the doctor or nurse will talk to you about what to expect during the test and will answer any questions you may have. Once you are comfortable they will proceed with the test.

First of all, you will be asked to undress from the waist down behind a screen. You will be given a sheet to cover yourself.
You will then be asked to lie back on the bed with your legs bent up in front of, feet together and knees apart. The nurse or doctor may ask you to change position during the test if necessary.
A speculum will then be inserted into your vagina. A speculum is a smooth, tube-shaped tool. Lubricant may be used to make insertion more comfortable.
The speculum will be opened to allow the practitioner to see your cervix. This portion of the test may be slightly uncomfortable but should not be painful.
They will then use a soft brush to take a small sample of cells from your cervix.
The speculum will be closed and removed and you will be left alone to get dressed.

Tips for Making the Smear Test More Comfortable for You

Smear tests can feel awkward and slightly uncomfortable but this should not be a reason to put them off.

Smear tests will always be carried out by a qualified medical professional who is used to carrying out the procedure. You are in full control of the appointment and can ask them to stop at any time.

If you are worried about your cervical screening appointment you could also try:

Wearing a skirt or long jumper that you can leave on during the test
Breathing exercises for relaxation
Bringing someone you trust with you for support
Ask the doctor or nurse to use a smaller speculum
Ask the doctor or nurse about a different position if you are uncomfortable or in pain
Bring something to distract you during the test such as a book or something to listen to

Remember that you can ask for the test to be stopped at any time.

How Often Should You Have a Smear Test?

How often you should have a smear test depends on your age. You will be invited for your first smear test up to 6 months before your 25th birthday via a letter in the post.

You will be invited for subsequent smear test appointments via the same method.

You should have regular smear tests every 3-5 years depending on your age.

Age	Smear Test Invitation
Under 25	Up to 6 months before turning 25
25 - 49	Every 3 years
50 - 64	Every 5 years
65+	Only if 1 of your last 3 tests was abnormal

Those under the age of 25 are not invited for smear tests as cervical cancer is extremely rare in those under 25 and it may lead to unnecessary treatment for abnormal cell changes that would have gone back to normal on their own.

Screening is usually stopped at 65, as people over this age are very unlikely to develop cervical cancer. You will however be invited again if 1 of your last 3 tests was abnormal. You will also not receive invitations if you have had a hysterectomy to remove all of your cervix.

If you are over the age of 65 and have never been for a smear test or haven’t been for one since you were 50, you can ask your GP for a test.

Similarly to this, if you missed your last appointment or have never attended a smear test, and are eligible, you do not need to wait for a letter to book an appointment.

Speak to your GP about cervical screening.

Smear Test Results

Cervical screening results are usually sent via letter to your home. They take approximately 2 weeks to arrive but may take slightly more or less time. You will be told during your appointment when to expect your results.

If they are taking longer than you expect, call your GP for an update.

The nurse or doctor should have explained what the potential outcomes of the test mean; however, the letter will also explain what your results mean.

There are 4 potential outcomes of the smear test:

Inadequate Result - Results were unclear. You will be invited back for another smear test in 3 months.
Human papillomavirus (HPV) is not found in your sample - HPV has not been found; your risk of cervical cancer is very low. You will be invited for another smear test in 3-5 years depending on your age. Most people will receive a negative result.
HPV found (HPV positive) but no abnormal cells - HPV has been detected but there have not been any abnormal cell changes. You will be invited for another smear test the following year and in year 2 if HPV is still present. If HPV is still present after 3 years you will be invited for a colposcopy.
HPV found (HPV positive) and abnormal cells - you will be invited for a colposcopy.

A colposcopy is a similar procedure to the smear test, designed to look at your cervix. It is carried out in a hospital and seeks to identify changes to the cells in your cervix.

It is important to note that the detection of HPV does not mean that you have cervical cancer.

FAQs

Do Smear Tests Hurt?

Smear tests are different for everyone but they should not be painful. Most people report mild discomfort during smear tests. If you do feel pain, you can ask the doctor or nurse to stop at any time. They may ask you to change positions or place your hands underneath your back to make the test more comfortable.

Certain psychological factors may make the test more uncomfortable. If you are nervous or tense, you may find the test more difficult. Try to relax and take a look at our tips for making the smear test more comfortable for you.

Do I Need To Do Anything Before a Smear Test?

You do not need to do anything before your smear test appointment; simply book your appointment on receiving your invitation letter. Once at your appointment, the doctor or nurse will explain everything you need to know to you. They will also be able to answer any questions or concerns you may have about the procedure.

How Do I Book a Smear Test?

You will be sent a letter in the post when it's time for you to book in for your cervical screening appointment. Most smear tests are carried out at your GP surgery by a female doctor or nurse. You can call your GP surgery to book your appointment or book an appointment online if you are able to.

If you missed your last smear test, you do not need to wait for a letter to book an appointment. Simply ring your GP surgery.

You should book your smear test as soon as you get invited. Try to time it so that you're not having a period – also try to avoid the 2 days before or after you bleed. If you are having treatment for unusual vaginal discharge or a pelvic infection, wait until treatment has finished to book your smear test.

Can I Have a Smear Test if I am Pregnant?

You will not usually need to have a smear test during pregnancy. Pregnancy can make it more difficult to get clear results.

If you are due a smear test whilst you are pregnant, you will usually be advised to rebook it for 12 weeks after giving birth.

You should always speak to your GP before attending a smear test whilst pregnant.

If you have had a previously abnormal result, your GP or midwife may ask you to have a cervical screening test at your first antenatal appointment. Find out more about cervical screening during pregnancy.

How Often Should You Have a Smear Test Over 50?

You should still have regular smear tests up until the age of 65. At 50 years old the frequency at which you undergo cervical screening decreases from every 3 years to 5 years.

Do I Still Need to Have a Smear Test If I've Had the HPV Vaccine?

Yes. The HPV vaccine does not protect against all types of HPV therefore you could still be at risk of cervical cancer.

The HPV vaccine is offered to girls and boys aged 12-13 as part of the NHS vaccination programme. It is designed to help offer protection against certain cancers caused by HPV including cervical cancer, some mouth and throat cancers and some cancers of the anal and genital area.

Are There Any Risks of Cervical Screening?

There are very few risks to cervical screening. You may experience spotting or light bleeding after your smear test. This is very common and nothing to be concerned about. It should stop by itself within a few hours.

Contact your GP if you experience heavy bleeding after a cervical screening appointment or if any bleeding does not stop after a few hours.

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