What is the NHS Cervical Screening Programme?

Cervical Screening (Smear Test) is routinely offered to women as part of a National Screening Programme between the ages of 25 and 64.

This test is not to diagnose cervical cancer. The test is to check the health of the cervix, which is the lower part of the womb - sometimes called the neck of the womb. For the majority of women the test will show that everything is fine but for 1 in 20 women there may be some changes in the cells that can be caused by many things. Most of these changes will not lead to cervical cancer. Since the 1980’s, cervical cancer rates have halved mostly due to women having regular smear tests.

Women should be called routinely every 3 years until the age of 50, then the frequency is reduced to 5 yearly. This invite should be automatically sent via your GP surgery. You can then decide if you wish to make an appointment with your GP or Practice Nurse for your cervical screen or you can attend one of our sexual health clinics. You can only have a cervical screen done if you have been called. Before your smear is taken, a national database that will be checked to make sure you are due for screening – this means it is important that we have your correct name, address and date of birth.

Cervical screening in the UK is for anyone with a cervix who is aged 25 to 64. This can include the following people if they have not had an operation to remove their womb and cervix (a full hysterectomy): trans men. non-binary people assigned female at birth. 

It's still important to attend cervical screening appointments if you've been vaccinated against HPV, as there's still a small chance you could get cervical cancer. 

What happens during the test?

The test does not take very long. You will need to undress from the waist down and lie on a couch. The doctor or nurse will then put a small instrument, called a speculum into your vagina to be able to see your cervix. A small brush is then used to pick up the cells from your cervix and transferred into a small container of liquid. This is then sent to the lab to be examined under a microscope.

Since the move to HPV primary screening only samples which are high-risk HPV detected have a cytology slide made for microscopical examination.  These slides are kept for 10 years.  The sample itself is disposed of when the result is authorised as the sample degenerates over time. 

A result letter detailing your result and recommended management is sent to your home address by CSAS (the call/recall service).  An electronic result also goes to your GP 

How reliable is the test?

No screening test in 100% effective but cervical screening is thought to save around 5000 lives per year and aims to detect pre-cancerous changes in the cervix before a cancer develops.

A false negative result is possible when testing for HPV and when looking for abnormal cells down the microscope but it is rare 

A false positive result is also possible, where cells are called abnormal which may not be on further investigation and review.  Again this is rare. 

 

Less than 1% of samples are reported as 'inadequate' as the laboratory are unable to report on the sample.  There are a number of reasons for this including: 

  • There may be a lot of inflammatory cells obscuring the cervical cells due to an infection 

  • The cervical cells have been hidden by mucus or blood 

  • There may not be enough cells on the slide to make an accurate assessment 

  • There may have been a technical problem with processing the sample 

If you have any unusual symptoms, such as bleeding after sex or between periods, you should see a doctor.

What if my test has an abnormal result?

If the result is abnormal you will be referred to the Colposcopy unit at your local hospital for further assessment and possible treatment 

In many cases, these changes resolve themselves but sometimes they continue to change and could possibly lead to cancer in the future. In such cases you would need to have a further examination which would show if you need treatment.

Treatment is simple and virtually 100% effective. The area of changed cells are removed from the cervix. Once this is done, you will have  a check-up. If everything is ok you will go back to the normal 3 yearly recall.

This treatment does not affect your fertility but it is recommended not to become pregnant until your abnormal cells are treated.

 

Further Information