This page gives information on:
- What will happen during the cervical screening (smear test)?
- What happens to the sample after the test?
- Helpful tips before your cervical screening
What will happen during the cervical screening (smear test)?
Your cervical screening appointment should take no longer than around 20 minutes, with the procedure itself taking approximately three minutes. In the UK, practice nurses take the majority of cervical screening samples, though sometimes it will be taken by a GP. If it is the first time you are attending your screening it can be helpful to find out as much as possible about what will happen beforehand.
You can bring a relative or friend with you if you need support and you can request a female practice nurse to take the sample if that makes you feel more comfortable. Before the procedure starts the practice nurse should explain what is going to happen and answer any questions or concerns you may have.
You will be asked to undress from the waist down (if you are wearing a skirt you can leave this on and just remove your knickers) and to lie on an examination bed on your back either with your legs bent up or with your ankles together and your knees apart. Some examination beds may have stirrups on them. If yours does you will need to place your feet in the stirrups. A paper sheet will be placed over the lower half of your body. Your practice nurse will then insert an instrument called a speculum into your vagina. Some clinicians may use lubricant on the speculum, which will make it easier to insert into your vagina. The speculum will be gently opened inside your vagina, allowing the nurse to see your cervix. The majority of speculums used for screening are made from plastic, but occasionally metal ones are used. A specially designed brush is used to take a sample of cells from your cervix. The nurse will collect the sample from the area of the cervix called the transformation zone. The sampled cells are immersed in a vial of liquid to help preserve them and are then looked at under a microscope in a laboratory.
What happens to the sample after the test?
In the laboratory, the contents of the vial are spun and treated to remove obscuring material. Cervical screening samples used to be spread directly onto a microscope glass slide; however, liquid-based cytology (LBC) is now always used in the UK because it is easier to see cellular material clearly under the microscope and reduces the number of unreadable screenings.
For most women cervical screening is not painful, but it may feel a little uncomfortable. Therefore, if you experience any pain or other problems please do let the doctor or nurse know. You may have some spotting (very light bleeding) for a day after the procedure.
The best time (if possible) for a cervical screening to be taken is in the middle of your menstrual cycle, halfway between one period and the next. This enables the cytologist to examine the best possible specimen and achieve the best possible report. Most GP surgeries will ask you to book the test yourself, so remember to take your menstrual cycle into account before you book your screening test.
In some areas of the UK, the sample of cells collected during the cervical screening will be tested for high-risk HPV rather than looked at under a microscope to look for abnormalities directly. If the sample is positive for HPV, the cells will then be looked at under a microscope and the woman may go for further investigation at colposcopy. You can find out more about this change and where it is happening on our HPV primary screening pages.
For many women the thought of going for cervical screening is often worse than the reality. Do not worry if you feel anxious about having your screening test, this is normal and many women feel like this. It can help to be as informed as possible about what having a cervical screening is like. Make sure you discuss any concerns with your practice nurse. The Jo’s Cervical Cancer Trust Helpline (0808 802 8000) is also open on weekdays (you can find the specific opening times here) should you want to talk about your cervical screening test.
Watch our film ‘Your Guide to Cervical Screening (smear test)’ to get more information on what will happen during cervical screening here.
A few points to remember before going for your screening:
- Do not have sexual intercourse 24 hours before your screening, as sperm, spermicidal gel and lubricants may make it difficult to get a good sample of cells from the cervix
- If you have been prescribed vaginal pessaries to treat an infection then postpone your screening for at least a week after the treatment has finished
- If you are using a vaginal oestrogen cream for menopause symptoms, do not apply it on the day of your screening or the two days beforehand
- Let your sample taker know if you have undergone FGM/cutting
- Do not douche or use a tampon for at least two days before your screening
- Speculums come in different sizes so you can ask for a smaller size if you are uncomfortable
- If you have been through or are currently going through the menopause you might find that the test has become more uncomfortable because, as you get older, the vaginal walls and opening can become smaller and less lubricated, which can make it more uncomfortable to insert the speculum during the smear test. If this is the case, you can ask your practice nurse to prescribe you a vaginal oestrogen cream/pessary, which can help to make inserting the speculum easier
- The sample taker should cover you with a paper towel; however, if you are feeling embarrassed wearing a skirt or bringing something from home to cover yourself with can help you feel more covered
- If it is your first time, you’re feeling nervous or you have had a bad experience in the past, tell your sample taker
- The more relaxed you are, the less discomfort you will feel
- If you don’t want to go in alone you can bring a family member or friend with you for moral support
- In some areas of the UK you don’t have to have your test done at your GP surgery, you can go to a sexual health clinic instead. For more information on sexual health clinics in your area and the services they offer, visit the below sites: England, Scotland, Wales and Northern Ireland.
Would you like to get involved with our work by helping us develop and improve our information and services? Visit the pages on our patient feedback group, Jo’s Voices, to see how to get involved.