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Cervical screening (a smear test) is a test that helps prevent cervical cancer. It identifies people who have a higher risk of developing it, so they can get the care they need.
A sample of cells is taken from your cervix and tested for cell changes (abnormal cells) caused by high-risk human papillomavirus (HPV). These changes can then be monitored or treated to prevent a cervical cancer developing.
Along with the HPV vaccine, cervical screening is the best way to protect against cervical cancer.
In the UK, about 5 million women and people with a cervix are invited to go for cervical screening each year. But about 1 in 4 people don't attend.
In the UK, anyone with a cervix between the ages of 25 and 64 is invited for cervical screening. People aged 25 to 49 are invited every 3 years and people aged 50 to 64 are invited every 5 years.
Everyone has a different experience of cervical screening. The test should not be painful, but some people find it uncomfortable. Rarely, people may have mild pain, although this does not last for a long time. You may have some light bleeding (spotting) after the test, but this is common and should stop after a day or so.
If you feel any pain or discomfort during the procedure, tell the nurse and ask them to stop. Remember, you are in control.
There is no difference between cervical screening and a smear test. They are two different names for the same test.
A smear test is the older name for the test. It was called that because of the way the test used to be done – cells were smeared on a glass slide, which was sent to the laboratory for testing.
The test is different now and most healthcare professionals call it cervical screening. Your letter will invite you to attend cervical screening, which is why we call it that in our information.
You will get a letter inviting you for cervical screening from the GP surgery you are registered with. You can call them to book a cervical screening appointment.
If you don’t want to have the test done at your GP surgery, in some areas of the UK you can go to a sexual health clinic instead. Check your local services to find out if they offer it.
It is usually recommended that you do not have cervical screening while you are or could be pregnant. If you are invited for cervical screening while pregnant, wait until 3 months after your baby is born to have the test. Tell your doctor or nurse you are pregnant if you are invited.
If you have previously had an abnormal cervical screening result, you may need to have the test while pregnant. Your doctor or midwife may ask you to have it at your first antenatal appointment. This test will not affect with your pregnancy.
Yes! All women and people with a cervix between age 25 and 64 should go for regular cervical screening, no matter their sexual orientation.
Most changes to the cells of the cervix (abnormalities) are caused by persistent infection with HPV. As HPV can be passed on through skin-to-skin contact in the genital area, sexually active LGBTQ+ people are still at risk of getting it. Our immune system usually gets rid of HPV, but if it can’t, it may develop into abnormalities that can eventually develop into cervical cancer without the right monitoring or treatment. Going for cervical screening is the best way to protect against cervical cancer, along with having the HPV vaccine.
Women and people with a cervix who have never been sexually active
When we talk about being sexually active, we mean:
- having vaginal, anal or oral sex
- touching in the genital area
- sharing sex toys.
Cervical cancer is rare in women and people with a cervix who have never been sexually active. This is because most (99.7%) cervical cancers are linked to high-risk HPV, which is usually sexually transmitted.
If you are not currently sexually active but have been in the past, it is recommended that you go for regular cervical screening.
Women and people with a cervix aged 65 or older
If you are aged 65 or older, you will not be invited for cervical screening if:
- you have had 3 normal results in a row in England, Scotland and Northern Ireland
- your last test was normal in Wales.
This is because it is very unlikely that you will develop cervical cancer.
If you are 65 or older and have had abnormal results, you will be invited for cervical screening until the cells go back to normal.
If you are aged 65 or over and have never had cervical screening, you are entitled to a test. You can speak with your GP surgery about booking an appointment.
Read more about cervical screening if you are 65 or older >
Women and people with a cervix who have had hysterectomies
If you have had a hysterectomy but still have your cervix, you may still be at risk of developing abnormal cells and should still go for regular cervical screenings.
If your womb and cervix have been removed to prevent or treat cancer, you may be asked to have a vaginal smear (vault smear) for a short time after. Your doctor will tell you about this.
If your womb and cervix have been removed for a non-cancerous (benign) condition, such as fibroids or heavy bleeding, you do not need to go for cervical screenings.
The general rule is if you do not have a cervix then you do not need to go for cervical screening.
The NHS says you should get your cervical screening results within 2 after your test, depending on where you live in the UK. The length of time varies and sometimes may be shorter or longer than this. You can ask your doctor or nurse when you should get your result.
Remember, how long it takes to get your result has no impact on the result of your test.
Both types of tests done on the sample of cells taken cervical screening are reliable.
Cytology, which looks for cell changes (abnormal cells) first, is 70% to 80% reliable. This means using cytology as the first test means we find about 7 or 8 in 10 cell changes.
HPV primary testing, which tests for high-risk HPV first, is 90% to 95% reliable. This means using HPV testing as the first test means we find about 9 in 10 cell changes. It is a more accurate test than cytology, which is why the UK is switching to this method of testing.
Read more about HPV primary testing >
With both tests, there is a small chance of getting an inaccurate result (between 20% and 30% with cytology, and between 5% and 10% with HPV primary testing).
Cervical screening is not 100% accurate. The test only takes a sample of cells from the surface of the cervix, which does not always show what is happening in the whole skin layer. However, cytology is between 70% and 80% reliable and HPV primary testing is 90% to 95% reliable. As the more accurate test, HPV primary testing is being rolled out across the UK.
No. It is important to remember that cervical screening is a screening test only. It gives a snapshot of cervical cells to identify whether there may be changes caused by high-risk HPV early.
If you have an abnormal result, you may be invited to colposcopy, so an expert can take a closer look at your cervix and diagnose any cell changes (abnormal cells). If these changes are not monitored or treated, they may develop into cervical cancer at some point in the future. This is why cervical screening is the best way to prevent cervical cancer, along with having the HPV vaccine.
Lots of people you feel anxious after getting an abnormal result, so you are not alone if you feel this way. But it is important that you understand what any cell changes are, so you can talk with your doctor about the results and get the right care and support.
No, it doesn’t. Most cervical screening results are normal, with a very small number being either inadequate or abnormal. Remember, most of these results show early changes to the cells of the cervix, not cancer.
Most cell changes (abnormal cells) and cervical cancers are caused by HPV. Almost all of us (4 out of 5 or 80%) will get HPV at some point in their lives, but less than 1 in 10 of us will need further tests after cervical screening. This is because some people’s immune system gets rid of HPV very quickly, before they develop cell changes.
We know that smoking can increase the risk of cell changes and makes it harder for our immune system to get rid of HPV. So if you smoke, stopping might help.
Remember, being invited for further tests does not mean you have cervical cancer.
No. Cervical screening is only designed to find high-risk human papillomavirus (HPV) or cervical cell changes (abnormal cells) that, if not monitored or treated, may eventually develop into cervical cancer.
It is your choice whether to go for cervical screening, whatever your age. If you are not sure whether to go, think about the benefits and any risks.
Along with the HPV vaccine, going for cervical screening when you are invited is the best way to protect against cervical cancer. But there are lots of reasons you may not want to have the test, including discomfort if you are going through or have been through the menopause. If you are anxious for any reason, we have lots of information about how to make cervical screening better for you, so you can make an informed decision about your health.
If you are 65 or over, you will stop being invited for cervical screening if you have had 3 normal results in a row. This makes it very unlikely that you will develop cervical cancer. If your recent cervical screenings results were abnormal, you will continue to be invited for follow up until the cells go back to normal.
If you are 65 or older and have never been for cervical screening, you are entitled to have one. You can speak with your GP surgery about booking an appointment.
Read more about cervical screening if you are 65 or over >
The most important thing is to be aware of the symptoms of cervical cancer. The symptoms can be caused by things other than cervical cancer, but whatever your age, see your doctor if you have any.
Everyone’s experience of cervical screening is different – something that still applies during or after menopause.
After menopause, the opening of the vagina and vagina walls may become smaller and less able to stretch. This can make putting the speculum into the vagina more uncomfortable.
For all of us, oestrogen levels in the body fall after menopause, which causes a condition called atrophic cervix. This just means that our cervical cells do not shed as easily, which may give an inadequate cervical screening result.
Although this can sound worrying, there are lots of things that may make cervical screening after menopause better for you, including:
- asking for a different sized speculum
- asking your nurse to prescribe local oestrogen, which can make it easier to put the speculum in
- telling your nurse if you are feeling uncomfortable so they can offer you the right support.
Yes! All people with a cervix between age 25 and 64 can go for regular cervical screening, no matter their gender identity.
Most changes to the cells of the cervix (abnormal cells) are caused by persistent infection with HPV. As HPV can be passed on through skin-to-skin contact in the genital area, sexually active LGBTQ+ people are still at risk of getting it. Our immune system usually gets rid of HPV, but if it can’t, it may cause cell changes that can eventually develop into cervical cancer without the right monitoring or treatment. Going for cervical screening is the best way to protect against cervical cancer, along with having the HPV vaccine.
No, cervical screening only looks at the cervix. It will not find any problems in the ovaries, the womb, the vulva or the vagina.
Human papillomavirus (HPV) primary screening is a way of testing the sample taken during cervical screening. It is sometimes called HPV primary testing or HPV testing. Instead of looking for cell changes (abnormal cells) first, this tests for a high-risk HPV infection. Your appointment and the way your sample is taken will be exactly the same, but the results letter you get will be a bit different.
Read more about different types of results >
HPV primary screening has been recommended by the UK National Screening Committee and UK government. It is thought that this way of testing will prevent more cases of cervical cancer than the current test (cytology only).
All four UK nations are moving to this way of testing. The changes are happening:
- in Wales, in September 2018
- in England, in late 2019
- in Scotland, in late 2019 to 2020
- date to be confirmed in Northern Ireland.