Cervical smears

Cervical smears check the health of your cervix (the lower part or neck of your womb), which connects to your vagina.

The test involves collecting a small sample of cells from your cervix for testing in a lab. It’s an effective way to detect and help prevent cervical cancer, which affects around 1 in 130 people with a cervix over the course of their lives.

What does cervical screening test for?

Cervical screening tests for human papillomavirus (HPV), which is the leading cause of cervical cancer.

Certain types of HPV cause changes in cervical cells, which make them more likely to become cancerous.

If these types of HPV are detected during cervical screening, a sample of cervical cells will be examined under a microscope. This checks for cell changes that could lead to cancer.

Why get a smear test?

Almost all cases of cervical cancer are caused by certain types of HPV. Cervical smears test for these types of HPV.

If you have a cervical smear test and HPV is detected, steps can be taken to prevent infected cells from developing into cervical cancer. A smear test can, therefore, potentially save your life.

Who can have a smear test? 

A smear test is a simple and effective way to prevent cervical cancer because it detects cell changes that could lead to cancer, allowing you and your care team to take appropriate action. 

The main cause of cervical cancer, HPV, is spread through skin-to-skin contact, which most often occurs through genital contact. It doesn’t require intercourse or ejaculation to be spread. All adults with a cervix who have had any type of sexual contact are advised to have regular smear tests.

In England and Northern Ireland, free NHS cervical screening is offered every 3 years to anyone with a cervix aged between 25 and 49 and every 5 years to anyone with a cervix aged between 50 and 64 years.

In Scotland and Wales, free NHS cervical screening is offered every 5 years to anyone with a cervix aged between 25 and 64.

With Spire Healthcare, in certain cases, you can have cervical screening before age 25 if you’re sexually active. You may need a referral from a GP to access this service.

When to have cervical smears outside of routine screening

If you have symptoms that could be caused by cervical cancer, don’t wait for your next routine cervical screening. See your GP as soon as possible.

They may recommend several tests, including a physical examination of your cervix, cervical screening and/or imaging tests.

Symptoms that can be caused by cervical cancer include:

• Pain during sex
• Pelvic pain
• Unusual vaginal discharge
• Vaginal bleeding after menopause
• Vaginal bleeding between periods
• Vaginal bleeding during or after sex

These symptoms can be caused by other conditions, but should always be investigated to rule out cervical cancer.

If you have any of the above symptoms and choose to have your smear test with Spire Healthcare, we strongly advise that you also see your GP as soon as possible. 

Who doesn’t need to have cervical screening? 

If you have a cervix but have never had any type of sexual contact — this includes touching without penetration — your risk of developing cervical cancer is low.

You may, therefore, choose not to have cervical screening. However, cervical screening will still be made available to you. If you are uncertain, you can discuss your options with your GP. 

You do not need to have cervical screening if you have had a total hysterectomy. However, if you have had a partial hysterectomy, where your cervix is retained, you still need to have regular cervical smears.

Cervical screening and pregnancy 

Although cervical screening is safe during pregnancy, it’s not usually recommended because hormonal changes during pregnancy can interfere with the accuracy of the smear test.

If you’re pregnant, your routine smear test will need to be rescheduled for at least 12 weeks after giving birth. Breastfeeding does not affect the accuracy of your smear test.

Your doctor may recommend a smear test during pregnancy if your last cervical smear showed abnormal cells or if your smear test is overdue ie you have not had one for at least 3 or 5 years. 

You can’t have cervical smears during your period. This is because blood produced during your period interferes with the accuracy of the smear test.

Book your smear test for a date after your period finishes. Ideally, you should avoid having your smear test on the 2 days before and 2 days after your period. This helps to make sure there are no traces of blood that could interfere with your test results.

Vaginal products and sex can also interfere with the accuracy of test results. You should avoid vaginal sex for 48 hours before your cervical screening, and avoid using vaginal medications, pessaries, creams, lubricants, spermicides and tampons for 2 days before your smear test.

On the day of your cervical smear, you will need to remove all clothing from your waist down. You may want to wear a dress or skirt that you can lift up or trousers that you can easily remove.

An empty bladder can make your smear test more comfortable, so you may want to have a wee before your test. 

Who will be involved? 

At Spire Healthcare, your smear test will be performed by a highly skilled nurse, and your results will be overseen by an experienced doctor. 

Our doctors are all registered with the General Medical Council and our nurses are all registered with the Nursing and Midwifery Council, so you can rest assured that you’ll receive expert care.

Cervical screening involves collecting a sample of cells from your cervix. This is performed while you’re lying down using a tube-shaped instrument called a speculum and a soft brush.

No anaesthesia is needed, so you’ll be awake during your test. You can bring a friend or family member for support, or you can ask the clinic or hospital to provide a chaperone.

Does it hurt? 

Cervical screening is not usually painful. However, you may feel some discomfort and feel that the process is quite intrusive. If you feel anxious about having a cervical smear test, it’s important to tell your care team so they can better support you. 

Cervical smears are only performed with your consent. If you consent to a smear test and then feel you can’t complete the test once it’s started, ask for it to be stopped immediately. You don’t need to give a reason for stopping, and you will be in control from start to finish.

You can also ask your nurse to pause the test and make adjustments to your position or their approach to make you feel more comfortable.

How long does the procedure take?

Cervical smears usually take around 5 minutes. However, your appointment will be longer so that you have time to get comfortable and ask any questions.

The procedure 

When you arrive for your cervical smear test, your care team will explain exactly what will happen and what you can expect after your test. You’ll be asked to sign an informed consent form to confirm that you understand what your test involves and what happens afterwards.

You will be asked to remove any clothing from the waist down and lie flat on your back on a patient table. A sheet will be used to cover the lower half of your body.

Next, you’ll be asked to bend your legs with the soles of your feet flat against each other and your knees facing outwards. #

Then, a single-use, plastic speculum will be gently placed into your vagina. A small amount of lubricant will be put on the speculum for comfort as it’s slid into your vagina.

The tube part of the speculum is made of 2 halves with a hinge that allows it to be gently opened wider. When the speculum is opened, your nurse can get a clearer view of your cervix.

A soft brush will be inserted through the speculum to collect a cell sample from your cervix. Then, both the brush and speculum will be gently removed.

The brush will be placed in a tube with a liquid preservative and sent to a lab for analysis. The lab will check for certain types of HPV that are linked to an increased risk of developing cervical cancer (high-risk HPV). 

When your smear test is finished, you’ll be given a paper towel to wipe away any lubricant from your genitals. You can then get dressed and return to your usual activities. 

Human papillomavirus (HPV)

What is HPV?

HPV is a family of over 200 different human papillomaviruses. Some infect the outermost layer of the skin, causing warts. Others infect moist surfaces (mucous membranes), such as those lining the genital tract, mouth and throat.

The types of HPV that infect mucous membranes are either low-risk HPV or high-risk HPV. Low-risk HPV very rarely causes cancer but can cause genital warts. High-risk HPV can, over time, cause cancer.

What does high-risk HPV mean? 

HPV can usually be removed from your body by your immune system. However, your immune system finds high-risk HPV harder to remove, so it can stay in your cells. Over time, high-risk HPV can cause abnormal changes to the size, shape and organisation of these cells. That makes it more likely that these cells will become cancerous in the future. 

It takes on average 15–20 years for cervical cancer to develop from cervical cells infected with high-risk HPV. This is why cervical screening is important — it gives you the chance to detect cells infected with high-risk HPV and take action to try and stop them from developing into cervical cancer. 

Cervical cancer

Cervical cancer causes abnormal cells in the cervix to grow uncontrollably. It is the 14th most common cancer in individuals with a cervix and incidence rates are highest in those between ages 30–34. Almost all cases of cervical cancer are caused by infection with high-risk HPV.

As cervical cancer grows slowly, it often doesn’t cause symptoms in the early stages.

Learn more about cervical cancer, its symptoms and treatment.

Your cervical screening results

Your cervical cell sample will be sent to a lab for testing. Your results will be ready in 2 weeks and will be sent to the doctor who made the referral, which is usually a GP.

You should, therefore, arrange a follow-up appointment with your doctor to discuss your results.

What the results mean 

There are 4 results you can receive for a cervical smear test:

• Negative — no HPV was detected; you can return for your next cervical screening in 3–5 years
• Unclear — the results were unclear because of an inadequate cell sample; you need to return for another cervical screening in 3 months
• Mixed — you tested positive for HPV, but your cervical cells look normal; you need to return for another cervical screening in 12 months
• Positive — you tested positive for HPV and your cervical cells look abnormal; you will be referred for a procedure called a colposcopy

What happens if you test positive? 

Getting a positive result after your cervical smear test doesn’t mean you have cancer. It means that changes in your cervical cells were detected that put you at increased risk of developing cervical cancer.

A colposcopy is the next step after a positive smear test. You’ll be asked to undress from the waist down and lie back with your knees bent. A speculum will be gently inserted into your vagina and opened up. A special microscope will then be positioned between your legs to get a clear view of your cervix. The microscope is not inserted into your vagina. A very small tissue sample will also be collected. 

Depending on the results of your colposcopy, your doctor will advise you on next steps. If your colposcopy confirms that you have cervical cancer, they will explain your treatment options for removing the cancerous cells and whether you need any further tests. 

Learn more about what happens after a positive smear test result. 

Bleeding after a smear test

As a smear test collects cells from your cervix, it’s normal to have some light bleeding (spotting) afterwards. This is because your cervix has been slightly irritated during cell collection.

Spotting usually stops within 2 days. You may want to wear a panty liner on the day of your test and the day after.

Irritation of your cervix can also cause some mild discomfort for up to 2 days after your smear test. You may, therefore, want to avoid vaginal sex during this time. 

Cervical cancer is preventable 

Cervical cancer is one of the most preventable cancers, and cervical screening plays a vital role in prevention.

Cervical smears can, therefore, be life-saving as they check for changes to cervical cells that happen before cancer develops. Detecting these changes early gives you the chance to prevent cervical cancer by following the advice of your doctor. 

Cervical screening is estimated to save at least 2,000 lives in the UK every year.