What is cervical screening?
Cervical screening is also known as the ‘smear test’ or ‘pap smear’. It is a test for high risk strains of Human Papillomavirus (HPV). Infection with HPV is very common and in most cases the immune system will clear the virus within about 18 months without it causing any harm. But if the virus is not cleared, over time it can cause changes to the cells of the cervix and eventually cause cervical cancer. This takes about 5-10 years or sometimes longer, meaning that regular cervical screening can detect HPV that isn’t going away and monitor for any cell changes so treatment can be started early.
What does a cervical screening test show?
If high risk HPV is not found during cervical screening it is highly unlikely for cervical cancer to develop. You will then be invited to repeat cervical screening every three or five years depending on your age.
If high risk HPV is found a further test is used in the lab to check for any abnormal cells. If no abnormal cells are found, an earlier follow up screen is arranged for 12 months’ time to ensure that the HPV has cleared.
If abnormal cells are found, you will be invited for another test, called a colposcopy. Having a colposcopy is similar to having cervical screening but the cervix can be examined in much closer detail to detect any abnormal areas and investigate or treat them through a biopsy or removal of abnormal cells (LLETZ procedure).
What happens during cervical screening?
During a screening test a trained nurse or doctor will use a speculum to look inside your vagina and see your cervix. They will use a small brush to collect cells from your cervix and send them to a lab. It can be uncomfortable but is not usually painful.
The examination will only take around 5 minutes but you should allow 30 minutes to 1 hour in total for your appointment.
Who is eligible for a cervical screening?
Everyone with a cervix aged 25-64 is recommended to have cervical screening. You should receive your first invitation just before your 25th birthday. Screening is usually recommended every 3 years until aged 50 (every 5 years in Wales and Scotland) and then every 5 years until 64.
We can only provide this service for you if your cervical screening is due, or overdue, for routine or follow up screening and/or you have had a letter inviting you to attend for the test. This is because samples taken prior to the correct due date will not be processed by the laboratory.
How do I book an appointment for cervical screening at SHAC?
We offer a limited number of routine cervical smear tests within our dedicated smear clinic on a Thursday mornings. This clinic is only for cervical smears and it is not possible to address other contraception & sexual health issues during these appointments – for this you will need to book a separate appointment.
You can book by telephoning on 01273 523 388. Alternatively, please book an appointment in our Smear (‘Cervical Screening’) Clinic (Thursday mornings at SHAC East). Trans and non-binary individuals can also book an appointment at Clinic T (every 2nd Wednesday evening of the month at SHAC East).
Information for trans masculine people about cervical screening
Everyone with a cervix aged 25-64 is recommended to have cervical screening. Unfortunately, if you are registered as male with your GP you won’t automatically be invited for screening. But if you speak to your GP practice they can often set up a recall on their electronic system to remind you when it is due. We understand that, for some trans people, cervical screening can be distressing especially for folks who experience dysphoria related to that part of the body. If you are taking testosterone you might experience dryness or soreness of the vagina which can make cervical screening more uncomfortable.
Everybody is welcome to have cervical screening at SHAC and all our staff are used to working with trans people. We will make sure your name and pronouns are respected and aim to make the experience as pleasant as possible, working with you to meet your needs.
If you prefer a dedicated trans service we are also pleased to be able to offer cervical screening at Clinic-T, our specialist sexual health clinic for trans and non-binary people. You can book an appointment for your cervical screening at Clinic-T by calling 01273 523 388, opt 1, or by using our contact form.
There are lots of ways cervical screening can be made easier for trans folks. If you would like to book an appointment in Clinic-T to discuss cervical screening as a trans person before having the screening appointment you are very welcome.
You may also find it helpful to watch this short video:
How to prepare for cervical screening
It’s normal to feel a little anxious about your cervical screening appointment, especially if its your first one or you’ve had a bad experience before. Although cervical screening can be a little uncomfortable, it shouldn’t be painful. However we understand that, for lots of reasons, people can find cervical screening difficult.
Sometimes it can be helpful to think beforehand about things that you would like to happen at your appointment so that you can let us know what you need in advance.
For example:
- You might prefer your appointment to be with a clinician of a certain gender. Whilst this is not always possible we will try to accommodate this. It’s best to contact us in advance in this case. You may also want a chaperone (a trained healthcare worker) to be present during your examination
- You might want to bring a trusted friend or family member with you for support. We will ask them to wait in the waiting area while we talk to you. This is clinic policy for everyone, and it gives you a space to ask any questions or discuss anything you may want to keep confidential. If you wish, we can then ask them to sit with you during the procedure. However, it is important that they do not obstruct the area the clinician is working in
- You will be given a paper sheet to cover up your lower half during the exam but you might like to bring a blanket or choose loose clothing like a skirt or long shirt to cover up instead
- Some people like the clinician to talk them through each stage of the examination whereas other people prefer that the clinician talked to them about something else, or didn’t talk at all. All of these approaches are valid, just let us know what you prefer. Some people find grounding or distraction techniques useful during the procedure – this might include square breathing , listening to music with headphones, a fiddle toy or exercises like the 5,4,3,2,1 technique
- Remember that you are in control of your body and of the procedure and you can stop the examination at any point. It may be useful to agree a word or hand signal in advance which will let the clinician know they need to stop
- Some people feel more comfortable or in control if they are able to insert the speculum to start with. Speak to your clinician if you would like to do this
- You might want to plan in advance how you are going to get home afterwards e.g. are you going to use public transport, drive, ask a friend for a lift?
Other frequently asked questions (FAQs) about cervical screening
Can I have cervical screening if I am under 25?
No, you can’t have cervical screening until you turn 25 and/or get a letter from the National Cervical Screening service. HPV is very common in people under 25 but almost all infections will be cleared by the immune system without doing any harm. Also, it takes at least 5-10 years and often much longer for cervical cancer to develop. This means that cervical screening for under 25s would be likely to give lots of positive results for HPV, but for almost everybody the HPV would never cause any harm. This could lead to a lot of extra tests and potentially treatments to the cervix for something the immune system would have cured naturally anyway.
There are still lots of things you can do to keep your cervix healthy. Why not look at the ‘How can I reduce my risk of cervical cancer?’ section below.
Can you have cervical screening when pregnant?
No, you can’t have cervical screening when pregnant. This is because the cervix changes in pregnancy which makes it difficult to interpret the screening test results. If you are invited to cervical screening when you are pregnant you should let your GP know so you can be invited again after your baby is born (usually three months after birth).
How long do cervical screening results take?
You will usually get your cervical screening result through the post. This can take 2-6 weeks
Can you have cervical screening on your period?
No, you can’t have cervical screening if you have your period or other bleeding from the vagina. This is because the blood can interfere with the test. So it’s best to book your cervical screening for the middle of your cycle (1-2 weeks after your period for most people). Bleeding from the vagina in between your periods or after sex could be a sign of infection or, rarely, cervical cancer so make an appointment to see one of our doctors or nurses to get it checked out.
Can you have sex before cervical screening?
If you use condoms or another barrier method of contraception, spermicide or lubricant it’s best to avoid vaginal sex for 24 hours before your screening appointment as these might affect the test result.
Is it normal to have bleeding after cervical screening?
It is normal to have a small amount of bleeding (spotting) after cervical screening. This should stop after 24-48 hours. You might want to bring a pad or wear period pants to your appointment just in case.
Do you need cervical screening if you are not sexually active?
Cervical screening tests for HPV, a common virus which can be passed on through many different types of sex. If you have had any type of sex or sexual touching with a person of any gender it is possible to have HPV and so cervical screening is recommended. If you have never had any sort of sex or sexual touching with another person your risk of HPV will be very low. However, you can still choose to have cervical screening if you want to.
Does my partner need treatment if I have an abnormal smear result?
Unless your partner shows symptoms of genital warts they will not need treatment, although we advise everyone to have regular sexual health screening. A diagnosis of HPV doesn’t mean that your partner has been unfaithful. HPV can have a long incubation period, and many people carry the virus without ever showing symptoms.
Partners of people with abnormal smears do not need to be tested for HPV nor receive treatment. There is no requirement for people to stop having sex if they are HPV positive on a smear. The body should naturally clear the virus without any treatment.
How can I reduce my risk of cervical cancer?
Regular cervical screening helps to detect any cell changes caused by HPV early, before they can cause cervical cancer so attending for cervical screening when called is a really effective way to prevent cervical cancer.
Stopping smoking is one of the best things you can do to protect your health. Smoking makes it more difficult for the immune system to clear HPV, which may allow it to hang around for longer and cause problems. You can get support to quit smoking from your GP or from local stop smoking service.
HPV vaccination protects against the most common strains of HPV, including those that most commonly cause cervical cancer. HPV vaccination is now offered to everybody at school during Year 8 (age 12-13). It’s important to know that HPV vaccination can’t prevent all cases of cervical cancer. So even if you have been vaccinated it’s still really important to attend for regular cervical screening.
Report any symptoms to your GP or visit a sexual health clinic to get checked out. Symptoms of cervical cancer can include bleeding in between your periods or after sex, a change in vaginal discharge or pain in your pelvis or lower tummy (especially after sex). If you have these symptoms it’s best to get checked out. It’s still not likely to be caused by cervical cancer, but it’s better to know for sure. These symptoms might also be a sign of something else important, like a sexually transmitted infection.
