About your cervical screening (smear) test

Going for screening could save your life

― What is cervical cancer?
― Can HPV be treated?
― What is cervical screening?
― About the test
― Your result
― What are the symptoms of cervical cancer?
― Further information

This leaflet tells you about cervical cancer and NHS cervical screening.

Cervical screening can prevent cervical cancer.
Anyone aged 25 to 64 who has a cervix can have screening.
Cervical cancer is caused by the human papillomavirus (HPV).
Most results are normal.
Sometimes more tests will be needed.
Going for your screening could save your life.

What is cervical cancer?

Cervical cancer is cancer of the cervix.

Every year there are about 160 new cases of cervical cancer in Wales. It is the most common cancer in women under the age of 35. Cervical screening can prevent cervical cancer from developing, or pick it up at an early stage.

Almost all cases of cervical cancer are caused by a virus called human papillomavirus (HPV). This is a very common virus that most people will have at some time during their life.

HPV is spread by skin-to-skin contact. For HPV in the cervix, this is through sexual contact with a person of any gender. This can be by having full sex, oral sex, genital touching or sharing sex toys. You or your partner could have had HPV for some time without knowing about it.

Only certain types of HPV cause cervical cancer. These are called high-risk types. These types of HPV can cause the cells on your cervix to change, and these changes can develop into cervical cancer.

Can HPV be treated?

There is no treatment to get rid of HPV. For most people, their immune system will deal with the virus. Most types of cervical cancer take a long time to develop. Treating cell changes early means that cervical cancer can be prevented.

What is cervical screening?

Cervical screening is also known as a smear test. A cervical screening (smear) test will look for high-risk types of HPV that can cause cell changes. By finding cell changes early, screening can prevent cervical cancer from developing.

Women aged between 25 and 64 years old are routinely invited for cervical screening every five years.

If you do not identify as a woman or are transgender, aged 25 to 64 and have a cervix, you can have cervical screening, but we may not be able to invite you. You will need to arrange screening with your doctor or clinic.

Your letter will ask you to book an appointment. You can have your cervical screening at your doctor’s surgery or at some sexual health clinics. If you would like to be seen by a female nurse or doctor, you can ask when booking your appointment.

About the test

A cervical screening (smear) test only takes about five minutes and is usually carried out by a nurse in a private room. Try to make an appointment for when you will not be having your period.

You will need to take off your underwear from the waist down.
You will need to lie on your back on a couch with your knees bent and your legs open.
The nurse will gently put a speculum (medical instrument) into your vagina so they can see your cervix.
They will then gently brush cells from the cervix using a soft brush.
The cells will be tested for high-risk HPV. If high-risk HPV is found, the sample will be looked at for cell changes.

The test should not be painful but sometimes it can be uncomfortable. Tell the person taking your test if it is very painful. You can stop the test at any time.

There may be some light bleeding after the test. This can be normal and does not mean anything is wrong.

It can be normal to feel embarrassed about having cervical screening, especially at your first appointment. Remember, your nurse carries out screening tests every day.
If you have never had sex, talk to your practice nurse to help you decide if you want to have screening.
Even if you have not had any sexual activity for a long time, it is still important you go for screening.
You can still get HPV if you only have one sexual partner.
You can take somebody with you for support.

Your result

You will receive your results letter in the post within four weeks of having your cervical screening. Your result will also be sent to your doctor.

Listed below are the possible results from HPV primary screening:

9 out of 10 results show no high-risk HPV

No high-risk HPV found (HPV negative) This is a reassuring result and you are at very low risk of developing cervical cancer. We will invite you for another routine screening test in five years' time, in line with UK guidance.

High-risk HPV found (HPV positive) but no cell changes If you have high-risk HPV, we will look at your sample for cell changes. If no cell changes are found, you will be invited for another test in 12 months' time. This is because the majority of people will clear the virus on their own within two years.

If you continue to test positive for HPV for the duration of three annual cervical screening (smear) tests; we will invite you for a colposcopy to check your cervix, even if you have no cell changes.

High-risk HPV found (HPV positive) and cell changes If you have high-risk HPV and cell changes, we will refer you to a specialist clinic called Colposcopy at your local hospital. Colposcopy is a closer examination of your cervix.

Inadequate result This means the laboratory was unable to give a reliable result. The screening test will need to be repeated after three months.

If you have any questions, or are worried about your result, contact Cervical Screening Wales or the person who took your test.

Important information about cervical screening

Benefits:

Cervical screening can save lives by preventing cervical cancer from developing.
Screening saves around 5,000 lives every year in the UK.
Screening can pick up changes to your cells even if you look and feel healthy.

Risks:

Screening does not prevent all cervical cancers.
You might be worried about going for cervical screening, talk to your doctor or nurse for support.
Some hospital treatments for cell changes may affect future pregnancies.

What are the symptoms of cervical cancer?

Early cervical cancer often has no symptoms. You should tell your doctor if you have any of the following, even if you have had a normal screening test:

Bleeding between periods, during or after sex or after the menopause (after your periods have stopped).
Unusual vaginal discharge.
Pain during sex, or lower tummy or back pain.

Smoking and risk of cervical cancer

Smoking doubles the risk of developing cervical cancer.

For free help to stop smoking call Help Me Quit on 0800 085 2219 or visit their website.

Further information?

If you have any questions about cervical screening, or would like information in Easy Read, British Sign Language (BSL), audio or large print, contact your local screening office or visit our website.

We welcome correspondence and phone calls in Welsh. We will respond to correspondence in Welsh without delay.

It is your choice whether to have screening or not. If you decide you do not want any more invitations, you can opt out by contacting your local screening office.

Visit Cervical Screening Wales’ website for information on:

What happens to your sample after you have been screened.
How we use patient information safely and securely.

For further information and support, visit Jo’s Cervical Cancer Trust