After cervical screening (a smear test), your sample of cervical cells is sent to a laboratory for testing. How your sample is tested depends on where you live in the UK. The types of testing are:
Our body is made up of cells – you can think of them as the building blocks of our body. Cytology is the study of individual cells in the body. In cervical screening, this means the sample of cervical cells taken during your test is looked at for changes.
Read more about cell changes (abnormal cells) >
If cell changes are found, what happens next depends on where you live:
England and Northern Ireland
If borderline or low-grade cell changes are found, the same sample is tested for high-risk HPV that causes most (99.7%) cervical cancers.
If high-grade cell changes are found, you are invited to colposcopy at your local hospital, where a specialist takes a closer look at your cervix.
Read more about colposcopy >
If any kind of cell changes are found, the sample is not tested again and you are invited to colposcopy.
From September 2018, Wales started using HPV primary testing to test cervical screening samples (see below).
HPV primary testing
This is sometimes called HPV primary screening or HPV testing. It is a test that looks at your sample for high-risk HPV that can cause cervical cells to change (abnormalities).
Read more about HPV >
HPV primary testing helps identify who is more at risk of developing cell changes or cervical cancer.
If high-risk HPV is not found, your sample does not need to be looked at for cell changes, as it is very unlikely you have or will develop them.
If high-risk HPV is found, the same sample will be looked at for cell changes:
- If cell changes are not found, your results letter will tell you when to come back for screening. You should be invited back in 1 year.
- If cell changes are found, you will be sent for more tests (colposcopy).
Read more about colposcopy >
When will HPV primary testing start?
HPV primary testing started in Wales in September 2018. In the rest of the UK, it is starting:
- In England from late 2019
- In Scotland from 2020
- In Northern Ireland the dates are to be confirmed.
What are the benefits of HPV primary testing?
- It is the best way to identify people at higher risk of developing cell changes or cervical cancer, because almost all cases (99.7%) are linked to high-risk HPV. The earlier we know if someone is at risk, the better chance we have of finding any changes early.
- It is a more accurate test than cytology. Cytology is between 70% and 80% reliable, while HPV primary testing is between 90% and 95% reliable. This means when we use HPV testing as the first test, we find about 9 in 10 cell changes (abnormal cells). A negative HPV test is also more reassuring than a negative cytology test, as cytology has more chance of being a false negative, which means any treatment could be delayed.
- It may mean we see self-sampling introduced in the future. There is ongoing research to find out whether self-sampling could be offered thanks to HPV testing. This would mean you could take the sample of cervical cells yourself, in the privacy of your home, which you may prefer.
Are there any risks of HPV primary testing?
Like all screening tests, HPV primary testing isn't 100% accurate. But the margin of error (between 5% and 10%) is small.
More information and support
Waiting for test results can be worrying, but remember we are here to support you. If you need to chat, call our Helpline on 0808 802 8000 or join our online forum and talk with others.
Read more about getting your cervical screening results >
- Public Health England, NHS Cervical Screening Programme: Colposcopy and Programme Management, 3rd edition, 2016.
- NHS Scotland, Scottish Cervical Screening Programme: Colposcopy and Programme Management, 3rd edition, 2017.
- O'Leary JJ. et al, Cervical screening: A new way forward (tests of risk and tests of disease), Health Research Board Open Research, 2018.