Dear Doctor: Smear test

I have been called in for a smear test for the first time but I’m really nervous. What is a smear test and why would I need one?

A smear test is where a doctor or a nurse obtains some cells from the cervix, the neck of the womb, in order to screen for pre-cancer and cancer.

The smear test is performed by passing a speculum, a small metal or plastic device, which is inserted into the vagina and allows either the doctor or the nurse to look at the cervix. The cells will be obtained from the cervix with what looks like a plastic brush.

Taking the test is often described as a bit uncomfortable, but it shouldn’t be painful, and it’s usually quite quick as well.

If the results come back as negative, meaning it hasn’t picked up any abnormal cells, it provides a high level of reassurance that the woman does not have cancer and is unlikely to develop a cancer within 2-5 years after the test.

An abnormal smear can mean different things depending on the degree of abnormality. The majority of women who have significant abnormalities, which we call high-grade abnormalities, are found to have a pre-cancerous condition and not an actual cancer.

If we can identify a pre-cancerous condition and deal with the problem early, we are often able to prevent the woman from developing cervical cancer. It is very unusual that the smear test identifies cancer, it occurs in less than five percent of the time.

There is no such thing as 100% secure test in screening. That is why we advise women who experience abnormal symptoms, such as bleeding after sex, bleeding between periods or persistent discharge, to speak to their doctor. They can consider further investigations or refer you to a specialist.

Mr Dirk Brinkmann is a Consultant Gynaecologist practicing at Spire Portsmouth Hospital

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