Cervical Screening: Smear Tests

Have you had a letter inviting you to have a smear test or been avoiding booking one?

It is not something anyone looks forward to and we understand! It is over in a matter of minutes and could be the best decision you make today.

Women and people with a cervix aged between 24 and 64 should have a cervical screening every 3 to 5 years to help prevent cervical cancer. The screening is quick and painless and can be done here in the practice.

If you are aged over 24 and have never had a smear test, or if it has been more than 3 to 5 years since your last screening, you should arrange an appointment with our Practice Nurse. You should not have the test while you are having a period or in the 4 days before or after your period as this can affect the sample.

What is cervical screening?

Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cervical cancer (the neck of the womb).

A sample of cells is taken from the cervix for analysis using a soft brush. A doctor or nurse inserts an instrument (a speculum) to open the vagina and uses a spatula to sweep around the cervix. Most people consider the procedure to be only mildly uncomfortable. The sample is then placed into a small plastic container and sent to laboratory. It is tested for the types of HPV that can cause cervical cancer. If you have a negative result for the most common types of HPV that cause cervical cancer, your risk of cervical cancer is very low and there is no need to check for abnormal cells even if you have had these in the past.

Early detection and treatment can prevent 75 per cent of cancers developing but like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer.

If you have a positive result for HPV the lab will check the sample for abnormal cells. Abnormal cells are not cancer, but they could develop into cancer if left untreated. Your result will be sent to your home and should arrive within 2 weeks of your test. As a next step the screening programme may offer you another examination (called a colposcopy) to look at your cervix more closely. If abnormal cells are found during colposcopy the cells will be removed. This is how screening can prevent cervical cancer.

Who is eligible for cervical screening?

All women and people with a cervix between the ages of 25 and 64 are eligible for a free cervical screening test every three to five years. The NHS call and recall system invites those who are eligable and are registered with a GP. It also keeps track of any follow-up investigation, and, if all is well, recalls them for screening in three or five years time. It is therefore important that all those needing screening ensure their GP has their correct name and address details and inform them of these change.

Those who have not had a recent test may be offered one when they attend their GP or family planning clinic on another matter. You should receive your first invitation for routine screening at 25.

Why are those under 25 not invited?

This is because changes in the young cervix are normal. If they were thought to be abnormal this could lead to unnecessary treatment which could have consequences for childbearing. Any abnormal changes can be easily picked up and treated from the age of 25. Rarely, younger people experience symptoms such as unexpected bleeding or bleeding after intercourse. In this case they should see their GP for advice.

Why are those over 65 not invited?

Those aged 65 and over who have had three consecutive negative results are taken out of the call recall system. The natural history and progression of cervical cancer means it is highly unlikely that you will go on to develop the disease. Those aged 65 and over who have never had a test are entitled to one.

What about those who are not sexually active?

The NHS Cervical Screening Programme invites all who are eligable between the ages of 25 and 64 for cervical screening. But if a person with a cervix has never been sexually active with a man, then the research evidence shows that their chance of developing cervical cancer is very low indeed. We do not say no risk, only very low risk. In these circumstances, a patient might choose to decline the invitation for cervical screening on this occasion. If a patient is not currently sexually active but has had male partners in the past, then we would recommend that they continue screening.

Booking an appointment

You will get a letter in the post inviting you to make an appointment. We have appointment available with our Practice Nurse on Mondays and Thursdays with a late clinic on Wednesdays until 7.00pm. You can book an appointment as soon as you get your letter. If you missed your last smear, you do not need to wait to be called again but can contact the surgery directly and we will be happy to book it for you.

Drop-in screening clinics

There is a Drop-in Screening Clinic held every Tuesday evening from 5.30 – 7.30 at Clinic 2, Centre for Women’s Health, Royal Devon University Hospital, Exeter you do not need to be referred to this service, as long as you have received your letter indicating your screening is due, or you are out of date, then you can just drop in without an appointment.

Support for LGBTQ+ people

All women between the ages of 25 and 64 who have a cervix – including lesbian and bisexual women - need to go for regular cervical screening tests. Trans men and nonbinary people who have cervixes should also attend regular screening but may not receive invitations through the national screening programme.

The LGBT Foundation and GOV.UK has information on their websites

Further information

Should you have any concerns around screening you can book a telephone appointment with our nurse to discuss them. Alternatively listed below are some really useful websites with lots of information.