Cervical Screening | Smear Test

Why This Test Is Done

How cervical screening helps prevent cancer

• Cervical screening checks the health of your cervix and helps find any abnormal changes before they can turn into cancer.
• Cervical screening checks a sample of cells from your cervix for certain types of Human Papillomavirus (HPV).
• These types of HPV can cause abnormal changes to the cells in your cervix and are called "high risk" types of HPV.
• If high risk types of HPV are found during screening, the sample of cells is also checked for abnormal cell changes.
• If abnormal cells are found, they can be treated so they do not get a chance to turn into cervical cancer.

How It Works

During the screening appointment, a small sample of cells will be taken from your cervix.

The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called "high risk" types of HPV.

What is HPV?

HPV is the name for a very common group of viruses.

Most people will get some type of HPV during their lives. It's very common and nothing to feel ashamed or embarrassed about.

You can get HPV from any kind of skin-to-skin contact of the genital area, not just from penetrative sex.

This includes:

• vaginal, oral or anal sex
• any skin-to-skin contact of the genital area
• sharing sex toys

Some types of high risk types of HPV can cause cervical cancer. In most cases your body will get rid of HPV without it causing any problems. But sometimes HPV can stay in your body for a long time.

If high risk types of HPV stay in your body, they can cause changes to the cells in your cervix. These changes may become cervical cancer if not treated.

If you do not have a high risk type of HPV it's very unlikely you'll get cervical cancer, even if you've had abnormal cell changes in your cervix before.

​Finding high risk HPV early means you can be monitored for abnormal cell changes.

Abnormal changes can be treated so they do not get a chance to turn into cervical cancer.

Who's At Risk Of Cervical Cancer

If you have a cervix and have had any kind of sexual contact, with a man or a woman, you could get cervical cancer. This is because nearly all cervical cancers are caused by infection with high risk types of HPV.

You're still at risk of cervical cancer if:

• you've had the HPV vaccine – it does not protect you from all types of HPV, so you're still at risk of cervical cancer
• you've only had 1 sexual partner – you can get HPV the first time you're sexually active
• you've had the same partner, or not had sex, for a long time – you can have HPV for a long time without knowing it
• you're a lesbian or bisexual – you're at risk if you've had any sexual contact
• you're a trans man with a cervix
• you've had a partial hysterectomy that did not remove all of your cervix

If you've never had any kind of sexual contact with a man or woman, you may decide not to go for cervical screening.

If you're not sure whether to have cervical screening, talk to your GP or nurse.

Cervical screening is a choice - it's your choice if you want to go for cervical screening. But cervical screening is one of the best ways to protect you from cervical cancer.

Preparing For The Test

If you're worried about cervical screening, there are things you can try that might make the test easier for you.

Do:

• wear something you can leave on during the test, like a skirt or long jumper
• bring someone with you for support
• try breathing exercises to help you relax– ask the nurse about these
• ask the nurse to use a smaller speculum if possible
• ask the nurse about lying in a different position – such as on your side with your knees pulled up to your chest
• bring something to listen to or read during the test

Don’t:

• do not feel pressured to keep going – you can ask to stop the test at any time
• try not to be afraid or embarrassed to talk to the nurse – telling them how you feel will help them understand what kind of support you might need

What Happens During The Test

During cervical screening a small sample of cells is taken from your cervix for testing.

It's usually done by a female nurse or doctor.

Before starting, they should explain what will happen during the test and answer any questions you have.

Your cervix is the opening of your womb from your vagina. A speculum (plastic or metal) and soft brush are used to take a sample of cells from your cervix.

How cervical screening is done

1. You'll need to undress, behind a screen, from the waist down. You'll be given a sheet to put over you.
2. The nurse will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart. Sometimes you may need to change position during the test.
3. They'll gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant may be used.
4. The nurse will open the speculum so they can see your cervix.
5. Using a soft brush, they'll take a small sample of cells from your cervix.
6. The nurse will close and remove the speculum and leave you to get dressed.

The cervical screening test itself should take less than 5 minutes. The whole appointment should take about 10 minutes.

After The Test

Things to look out for after cervical screening

You may have some spotting or light bleeding after your cervical screening test.

This is very common and should go away after a few hours, but contact your GP surgery if you have any concerns.

​See a GP if you've had cervical screening and have:
- heavy bleeding
- spotting or light bleeding that does not stop after a few hours

The nurse or doctor will tell you when you can expect your results.

If you've waited longer than you expected, call your GP clinic to see if they have any updates.

Try not to worry if it is taking a long time to get your results letter. It does not mean anything is wrong, and most people will have a normal result.

What your cervical screening results mean

Your cervical screening results letter will explain if human papillomavirus (HPV) was found in your sample, what your result means, and what happens next.

Sometimes you'll be asked to come back in 3 months to have the test again. This does not mean there's anything wrong, it's because the results were unclear. This is sometimes called an inadequate result.

HPV is not found in your sample

Most people will not have HPV (an HPV negative result).

This means your risk of getting cervical cancer is very low. You do not need any further tests to check for abnormal cell changes in your cervix, even if you've had these in the past.

You should be invited for screening again in 3 or 5 years.

HPV is found in your sample

There are 2 different kinds of HPV positive result:

Having a positive HPV result does not mean your partner has had sex with someone else while you have been together. You might have HPV even if you have not been sexually active or not had a new partner for many years.

If you need a colposcopy

A colposcopy is a simple procedure to look at your cervix. It's similar to having cervical screening, but it's done in hospital.

You might need a colposcopy if your cervical screening results show abnormal changes to the cells of your cervix.

Try not to worry if you have been referred for a colposcopy.

When Cervical Screening Is Not Recommended 

In the UK, cervical screening is offered to:

• Women aged 25 to 64.
• Screening starts at 25 years old because cervical cancer is very rare in younger women, and abnormal cell changes often return to normal without treatment in this age group.
• Screening usually stops at 65 years old, unless a recent test was abnormal.

If you've had a total hysterectomy (removal of the womb and cervix), cervical screening is no longer needed.

Regional Guidance

In many Southeast Asian countries, the recommended age for cervical screening may vary based on local healthcare guidelines. For example:

• Some countries start screening as early as 21 years old, particularly if women are sexually active.
• Screening may extend beyond 65 years old for those at higher risk or with limited access to previous screenings.

What Should You Do?

• Consult your doctor to find out the appropriate age and frequency for cervical screening in your country.
• Follow local health policies or international recommendations to ensure regular screening and early detection.

Risks

You may have some light bleeding or spotting after cervical screening. This should stop within a few hours.

If abnormal cells are found and you need treatment, there are some risks, such as:

• treating cells that may have gone back to normal on their own
• bleeding or an infection
• you may be more likely to have a baby early if you get pregnant in the future – but this is rare

​See a GP if you're worried about symptoms of cervical cancer such as:
- bleeding between periods, during or after sex, or after you've been through the menopause
- unusual vaginal discharge

Do not wait for your next cervical screening appointment.