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About cervical screening

 

  1. Sasieni P. et al, Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data, BMJ, 2009.
  2. Public Health England, NHS Cervical Screening Programme: Colposcopy and Programme Management, 3rd edition, 2016.

 

 

Cervical screening (a smear test) is a free health test that helps prevent cervical cancer. It checks for a virus called high-risk human papillomavirus (HPV) and cervical cell changes (abnormal cells).

We also have information about:

What is cervical screening?

Cervical screening is a free health test available on the NHS as part of the national cervical screening programme. It helps prevent cervical cancer by checking for a virus called high-risk HPV and cervical cell changes. It is not a test for cancer. 

Read about HPV >

You might hear cervical screening being called a smear test. This is just a different name for the same test. 

It is your choice whether to go for cervical screening. We hope this information helps you make the best decision for you and your health.

Who can have cervical screening?

You can have cervical screening if you have a cervix. This includes trans and non-binary people with a cervix.

In the UK, you are automatically invited for cervical screening if you are:

  • between the ages of 25 to 64
  • registered as female with a GP surgery.

You are invited:

  • every 3 years between age 25 and 49
  • every 5 years between age 50 and 64.

You may get your first invite up to 6 months before you turn 25. You can book an appointment as soon as you get the invite.

It is very rare to develop cervical cancer:

  • under the age of 25
  • over the age of 64, if you have had regular cervical screening. 

We have more information if you are under 25 or if you are 65 or over. If you are worried about any symptoms, you should get them checked by your doctor or nurse, whatever your age.

Read more about symptoms of cervical cancer >

Cervical screening when you are pregnant

It is usually recommended that you do not have cervical screening while you are or could be pregnant. Pregnancy can make the result of your test harder to interpret.

If you are invited for cervical screening while pregnant, tell your doctor or nurse you are pregnant. You should wait until 3 months after your baby is born to have the test. 

If you need follow-up after an abnormal cervical screening result or treatment for cell changes, you may need to have the test while pregnant. Your GP or midwife may ask you to have it at your first antenatal appointment. This test will not affect your pregnancy.

If you are planning a pregnancy

Check with your doctor or nurse whether you are up to date with your cervical screening. This means that any tests or treatment can be arranged around the pregnancy.

Cervical screening after treatment 

If you have previously had treatment that affected your cervix for any reason, you may no longer be invited for cervical screening. These treatments include:

  • A hysterectomy. This is an operation that removes the womb and cervix. If you have had a hysterectomy, you will not be invited for cervical screening as there is no cervix to take a sample of cells from. 
  • Pelvic radiotherapy. This is a treatment that directs radiation at the part of the body between the hipbones (pelvis). It can damage the cells of the cervix and make it harder to tell if there are any changes, so you may not be automatically invited for cervical screening. Your doctor may do a separate follow up appointment with you.

Cervical screening and HIV

HIV can make your immune system very weak, meaning it is not as able to get rid of HPV that causes most cervical cancers. If you have HIV, speak with your healthcare team about going for cervical screening every year. Annual cervical screenings are usually taken outside of the NHS National Screening Programme. 

What are the benefits and risks of cervical screening?

As with any test, there are benefits and risks of cervical screening. You are invited for cervical screening because evidence shows that the benefits of the test outweigh any risks.

Benefits of cervical screening

  • Cervical screening prevents about 75% of cervical cancers. Along with the HPV vaccine, it is the best way to protect against cervical cancer.
  • Cervical screening looks for cell changes caused by high-risk HPV before they develop into cervical cancer. This means you can get any treatment or care you may need early.
  • Cervical screening is an effective test and the UK-wide switch to HPV primary screening will make it even more so. Across the UK, cervical screening will test your sample of cervical cells for HPV first. If HPV is found, it will then look for cell changes in the same sample. This means we can identify those with the highest risk of developing cervical cancer, so they can get the right care. It also means less women overall will need to go for further tests.

Possible risks of cervical screening

  • In a few cases, the test will say you do not have HPV or cell changes when you do. This is called a false negative. Going for cervical screening when invited can help reduce this risk, as it is likely HPV or cell changes that were missed would be picked up by your next test.  
  • In a few cases, the test will say you do have HPV or cell changes when you don’t. This is called a false positive. It may mean you could be invited for tests or treatment that you don’t need.
  • Sometimes cell changes go back to normal without needing treatment. At the moment, we can’t tell which cell changes will go back to normal, so treating means we can be sure we are preventing them from developing into cervical cancer. This means some people may have unnecessary treatment, which is called overdiagnosis or overtreatment. The move to HPV primary screening will help prevent this. 

It is hard to know exactly how many people are affected by these risks. But we do know, for those aged 25 to 64, the benefits of cervical screening in preventing cervical cancer are great. 

If you decide not have cervical screening, ask your GP to be removed from their invite list. If you change your mind, you can ask your GP to add you back to the list.

Read more about opting out of cervical screening on the Gov.uk website >

Cervical screening FAQs

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.

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. 

All women and people with a cervix between age 25 and 64 can go for regular cervical screening, no matter their sexual orientation or gender identity.

Most cervical cell changes and cervical cancers are caused by persistent infection with HPV. As HPV can be passed on through any skin-to-skin contact in the genital area, anyone having any kind of sex is at risk of getting it. 

Read more about HPV and how it affects us >

No. Cervical screening is only designed to find high-risk HPV or cervical cell changes that, if not monitored or treated, may eventually develop into cervical cancer.

No. Jo's Cervical Cancer Trust is a charity independent of the national cervical screening programme, GP surgeries and other clinics and cannot opt you out of the cervical screening programme. It is best to contact your local GP and ask to be removed from the invite list.

Read about opting out of cervical screening >

More information and support about cervical screening

We know that cervical screening isn’t easy for everyone and we have lots of support available if you are worried about the test.

Read our tips for making cervical screening better >

  • Our trained Helpline volunteers can talk you through the appointment, as well as ways to make the test better for you – call them free on 0808 802 8000. Check our Helpline opening hours >
  • If you have a medical question about cervical screening and what it is for, we have a panel of experts ready to help. Use our Ask the Expert service >
  • Sometimes talking to other people who have been for cervical screening can help. On our Forum you can chat or read through lots of conversations about the test and pick up some useful tips. Join our online Forum >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it. 

References

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

Cervical screening FAQs >

Read answers to common questions about cervical screening.

Date last updated: 
08 Jan 2020
Date due for review: 
08 Jan 2022

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