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Frequently Asked Questions on Cervical Screening

This page is a selection of different questions that Jo’s Cervical Cancer Trust has received about cervical screening. The answers have been reviewed by Jo’s Cervical Cancer Trust medical advisers.

Why should I attend my cervical screening invitation? 
How many women attend for screening in the UK?
Who is eligible for a cervical screening on the NHS? 
Is having a cervical screening painful? 
Can I go for my cervical screening when I am pregnant? 
Should lesbian and bisexual women have cervical screenings?
Is there anyone who may not need to go for a cervical screening? 
Are the results of cervical screening reliable? 
Why are some cervical abnormalities missed? 
Will a cervical screening give a final diagnosis?  
Does an abnormal cervical screening mean I have cancer? 
Why do some women get abnormal results and others never do?
Is having a cervical screening like having a gynaecological MOT? 

Why should I attend my cervical screening invitation?
Cervical screening is a method of examining cells from the cervix. Screening can detect pre-cancerous/abnormal cells in order that they can be treated to prevent the occurrence of cancer.

How many women attend for screening in the UK?

Around five million women are invited to attend for screening each year. Since 1997 the numbers of women attending for screening in the UK has ranged from 83% to 77%. There has been a recent and worrying trend in fewer women attending screening; especially in the 25-34 age group, where in 2011/12 one in three didn't take up their invitation. And in the 50+ age group where numbers attending has been decreasing for the last three years.
 
Who is eligible for a cervical screening on the NHS?
Eligibility varies according to country:

England,
Northern Ireland
& Wales

Women aged 25 to 49 invited every three years
Women aged 50 to 64 invited every five years

Scotland* Women aged 20 to 60 invited every three years

*In 2012 the UK National Screening Committee recommended a uniform screening age of 25 to 64 across all UK countries. These changes are due to be implemented in Scotland from 1st April 2016.

Is having a cervical screening painful?
Around five million women have a cervical screening every year; 90 to 94% of whom receive a normal result. The procedure should not be painful but some women can experience a degree of discomfort and even short-term mild pain. Being screened, (especially if it's the first one) can be daunting for some, so it may help if you find out beforehand exactly what happens during a cervical screening appointment.

The appointment should take no longer than around 15 minutes with the procedure taking approximately three minutes. If you feel any pain and/or discomfort during the procedure please inform the GP/practice nurse.

Can I go for my cervical screening when I am pregnant?
Every woman's screening history is different and offering a cervical screening when she is (or might be) pregnant will be dependent on this history. If you have had abnormal result in the past or never had a cervical screening or had not attended previous invitations for screening, then you should consult your doctor or practice nurse to ask for advice.

Should lesbian and bisexual women have cervical screenings?
Yes, all women regardless of their sexual preference who are over the age of invitation should have regular cervical screening. Most cervical abnormalities are caused by persistent infection with HPV. As HPV can be transmitted through skin-to-skin contact in the genital area, gay women are at risk of contracting HPV and experiencing abnormal cervical changes and thus, should always attend when invited for cervical screening.

Is there anyone who may not need to go for a cervical screening?
A small minority of women may not need a cervical screening:

  • Women who have never been sexually active

The incidence of cervical cancer is extremely rare in women who have never been sexually active and the guidelines issued suggest that women who are sexually active attend for screening at the age of 25. More than 99% of cervical cancers are linked to infection with sexually transmitted HPV so it is recommended that if you have had sexual intercourse or genital-to-genital contact with a man or a woman, even just once, then you should attend for regular cervical screenings.
If you are not currently in a sexual relationship but have been in the past, you are recommended to have regular cervical screening.

  • Women over 65

Women aged 65 and over who have had three normal test results in a row are not called back for further cervical screening tests. It is very unlikely that women in this category will go on to develop cervical cancer.

If you are over 64 and have had abnormal results, you will continue to be invited for screening until the cells return to normal. Women aged 65 and over who have never had screening are entitled to a test.

If you have never had a screening test and have been sexually active, you should have a test, regardless of your age.

Some women who have had a hysterectomy are still thought to be at risk of developing abnormal cells and so should continue to have regular cervical screenings. For example if your womb was removed but you still have your cervix, you should continue to go for regular screening. If your womb and cervix were removed to prevent or treat cancer, you may still be asked to have a vaginal smear (vault smear) for a short period of follow up.

If your womb and cervix were removed for a benign (non-cancerous) condition, such as fibroids or heavy bleeding, you do not need to have any more cervical screenings. In general if you do not have a cervix, then you do not need to attend a cervical screening.

Are the results of cervical screening reliable?
Cervical screening is 80% to 90% reliable and can prevent 60 to 80% of cervical cancers. This means that seven cases can be prevented out of every 10 women who would have developed cancer of the cervix [1].

Why are some cervical abnormalities missed?
There are several factors in the taking and reading of cervical screenings which makes it impossible to be 100% accurate. A cervical screening is a sample of cells taken from the surface of the cervix. Because it is only a sample, the cervical screening does not always accurately reflect what is occurring in the whole of the skin layer - and it is the latter which is important to make an accurate as possible diagnosis and of course attend screening when invited.

Will a cervical screening give a final diagnosis?

No. It is important to remember that cervical screening is a screening test and not designed to give a final diagnosis. It is used to detect early cervical cell abnormalities which, if left untreated, could lead to the development of cervical cancer at a time in the future. It is understandable to feel anxious if you receive an abnormal result but it is more important that you know and understand what the abnormality is so you can discuss the results with your doctor and arrange appropriate follow-up.

Does an abnormal cervical screening mean I have cancer?

No. The vast majority of cervical screening results are normal but a very small percentage of the total screenings reported on every year are described as being either 'inadequate' or having a grade of abnormality. The majority of these abnormalities reflect pre-cancerous changes in the cells of the cervix, not cancer.

Why do some women get abnormal results and others never do?
Almost all women will be infected with HPV at some point in their lives, but less than one in 10 will have an abnormal screening result. We do not know why this is. In some women it may be related to the immune system's ability to get rid of this virus quickly.

If cervical cell abnormalities have been detected this does NOT mean that you have cervical cancer or will get cervical cancer in the future. What it does mean is that some of the cells are slightly abnormal and that if left untreated could go on to develop into cervical cancer at a later date.

Medical research has yet to establish why some women have persistent HPV infection, develop abnormal cell changes, or cervical cancer. This is why it is important for all women to attend their NHS invitation for a cervical screening.

Is having a cervical screening like having a gynaecological MOT?
No. Cervical screening is designed solely to detect early cervical cell abnormalities which, if left untreated, could lead to the development of cervical cancer at a time in the future. It is not designed to detect abnormalities in the ovaries, the womb, the vulva or the vagina. However, having a regular cervical screening does give the opportunity for the cervix to be examined.


References

  1. Sasieni et al. 2009. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 339, 1-7.
Date last updated: 
29 Jul 2014
Date due for review: 
29 May 2015