Smear Tests - The Complete Guide
Clinical surveys done by the NHS and Jo’s Cervical cancer Trust show that Cervical screening rates among all ages are at their lowest for the last two decades mostly due to fear and embarrassment women have towards this procedure.
It’s time to demystify the smear test!
We share everything you need to know about smear tests and give you the confidence you need to make and attend your screening.
What is a smear test?
A smear test, also known as a pap smear or cervical screening, is a test that checks for any abnormal changes in the cells of the cervix in order to prevent cervical cancer from developing.
It is generally a quick procedure that lasts at most a couple of minutes.
The cervix is the opening to your womb from your vagina. Abnormal cell changes are normal and often improves naturally.
Who should get a smear test?
Everyone with a cervix. So women with a cervix, transgender man or people who don’t identify as women but have a cervix.
How often should I have a smear test?
Between the ages of 25 and 49, you will be invited to get a screening every 3 years. From the age of 50 onwards every 5 years.
However, the frequency may change depending on your results. For example, if abnormal cells are detected, you may be asked to come back every year even if once they have cleared out.
Moreover, the frequency of the tests may increase if you are HIV positive or have a weak immune system due to chemotherapy or organ transplant.
| Age | Frequency |
| < 25 years old | no screening needed |
| 25 – 49 | every 3 years |
| 50 – 64 | every 5 years |
| 65 onwards | you may no longer need one |
Why should I get a smear test?
The screening mainly identifies the changes that have a probability to form into cancer cells, hence this is an effective way of preventing Cervical cancer. Abnormal cell changes do not have any symptoms and therefore you will not be able to detect them unless you have a Cervical screening.
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Where can I get a smear test?
In the UK smear tests are performed either at your local GP or at a sexual health clinic.
Can I request a smear test early?
You can book an appointment as soon as you receive your letter. If you have missed your Cervical screening appointment, then you do not need to wait for another letter to book an appointment.
How do I prepare for a smear test?
Avoid intercourse, douching, or inserting anything in the vagina, including medication for at least two days prior to the test, as it could make getting a sample more challenging. Also, try not to schedule your test during your menstrual period.
There is no medical reason stating that taking a shower would alter the result, hence showering before the test is completely your decision.
Wear comfortable clothes as the Doctor would need you to be relaxed while taking the test, so make sure you are comfortable.
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What is the procedure for a smear test?
The screening is just a 5-minute procedure in which the nurse or doctor would gently put an instrument called a speculum in your vagina just enough to see your cervix and sweeps a sample of cells using a small soft plastic brush.
This procedure is painless but could feel uncomfortable as it is foreign to the body.
Can I get a smear test during a lockdown?
Smear test invitations and procedures are the same even during the lockdown, but your GP or clinic will be following all COVID guidelines and will guide you through the various measures taken to avoid risks.
Does a smear test make you bleed?
In most cases a smear test will not make you bleed nor will it feel uncomfortable. However, it could happen that you experience very light vaginal bleeding and cramping up to a day after the test.
This is normal and nothing to worry about and will go away without any intervention. This usually occurs because the Pap smear can irritate the blood vessels in the cervix thereby causing them to bleed.
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Can you have a smear test when you are pregnant?
If it’s a routine smear, for example, your 3-year invitation. you can delay getting your test done until after you have given birth.
However, if you’re having the test as a follow-up of an abnormal result, then you should still have your test done.
More advice on smear tests and pregnancy >
When can I get the results of my smear test?
In most cases, you would receive a letter with your test results within 2-4 weeks. However, if necessary the doctor might also contact you.
What do the results of a smear test mean?
Pap smear test results are divided into two; Normal and Abnormal. Normal results, or Negative results, show that there were no abnormal cells identified and you will not need to take further action.
Abnormal results do not mean you have cancer. These are abnormal cells that could be precancerous.
However, these days, apart from cell abnormalities, laboratories also check for high-risk strains of Human papillomavirus (HPV).
If no such strains of HPV are found, there is mostly nothing to be concerned about. Hence the possibilities of the results are:
- No abnormal cells + High-risk strains of HPV not found :
– you will be invited for another screening 3 years later if you are under 50 years of age, or 5 years later if you are above 50. - No abnormal cells + High-risk strains of HPV found :
– you will be invited back for another screening in 1 year. Chances are that the high-risk HPV strains would be gone by then, but if it’s found 3 times in a row, you will be referred to colposcopy. - Abnormal cells with borderline/low-grade cell changes + High-risk strains of HPV not found :
– you will be invited for another screening in the normal time interval of 3 to 5 years based on your age. - Abnormal cells with borderline/low-grade cell changes + High-risk strains of HPV found :
– you will mostly be invited for colposcopy. - Abnormal cells with High-grade cell changes :
– you will be invited for colposcopy regardless of the HPV strain result.
What are the symptoms of cervical cancer to look out for?
Cervical cancer symptoms that need to be looked out for are
- Vaginal bleeding or unusual discharge
- bleeding after sex
- bleeding between periods
- pain during sex
- pain in your pelvis
The first step will be to get a Cervical screening to assess if there are any abnormalities.
Should I get a smear test even if I haven’t had sex?
Smear tests are recommended for all women over 25. However, the chances of getting Cervical cancer reduces if you have never had sex.
This is because HPV, a sexually transmitted infection, is one of the main causes of cervical cancer which is transmitted through skin-to-skin contact.
Can I have yearly cervical screening tests?
It is advised not to have the test yearly, as Cervical cancer takes a long time to develop and in most cases abnormalities can improve and clear out without treatment.
Nonetheless, your doctor will notify you if you need to test more frequently.
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Are pap smear tests accurate?
Research has proven that Pap tests are very accurate, and regular screenings can reduce Cervical cancer rates and mortality by at least 80%.
Don’t fear the smear!
Cervical cancer rates are very less under the age of 25, but the rates tend to peak in the age range of 25-29 and then slowly drop with age.
A survey done by Jo’s Cervical cancer trust revealed that 61% of the women in the age group of 25-35 were unaware that they were the most vulnerable. smear tests save about 5000 lives in the UK every year and help prevent Cervical cancer in 75% of the cases.
About one in four eligible women tend to not take up the Pap test due to anxiety or lack of information, despite its high life-saving potential.
Smear tests are nothing to fear, but if you do feel uncomfortable or embarrassed, do speak with the nurse performing the test. She will guide you through it and explain what is happening at every stage.
Book your appointment by contacting your GP!
Reference
- The Guardian (2021) -smear tests: women asked to discuss fears as test rate plummets
- Macmillan cancer support (2020) – smear test Cervical screening test
- Jama Network – US Preventive Services Task Force (2018) – Screening for Cervical cancer – US Preventive Services Task Force Recommendation Statement
- Healthline media (2020) – Pap smear (Pap test): What to Expect
- cancer.net editorial board (2018) – https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/pap-test
- National cancer Institute – HPV and PAP Testing – https://www.cancer.gov/types/Cervical/pap-hpv-testing-fact-sheet
- Verywell health (2020) – Overview of the Pap smear Procedure
- https://www.verywellhealth.com/what-is-it-like-to-get-a-pap-smear-3132772
- Patient.info (2018) – Dr Mary Harding – https://patient.info/search.asp?searchterm=smear%20test
- Patient.info (2018) – Abi Miller, reviewed by Dr Sarah Jarvis MBE – https://patient.info/news-and-features/how-to-handle-smear-test-anxiety