Cervical screening

Cervical screening (previously known as a smear test) begins at the age of 25 in the UK. Around the time of your 25^th birthday you may receive a letter inviting you to book your first screening appointment. If you are registered as male on your records, you will not get a letter asking you to book your appointment. At the age of 25 you can contact your GP, or a specialist clinic to book your screening test.

You will be eligible for your next screening test every three to five years until the age of 50 (depending where you live in the UK), and then every five years until the age of 64, if your screening tests are normal.

If you are over 65 and were HPV positive at your last screening or have cervical cell changes, you would continue to be screened until you have completed the NHS monitoring pathway.

If you are over 65 and have never been screened, you are entitled to a test if you ask your GP.

Some people with a cervix may experience discomfort or pain when having cervical screening, there are several reasons for this which may be physical or psychological. This discomfort is more common if you are taking testosterone. It is important to chat to your doctor or nurse about this and there are things you can do to make the test less uncomfortable. These include asking your doctor or nurse to use the smallest speculum. We have some tips for you here and you can contact our Ask Eve information service for more information.

Anyone with a cervix is at risk of developing cervical cancer. If you are a trans man, are transmasculine, or a non-binary person who has a cervix (if you haven’t had a total hysterectomy which removes the womb and cervix), we understand that attending a cervical screening appointment may be emotionally and physically difficult for you. It can be helpful to have a separate appointment with your nurse or doctor beforehand, and talk through the process with them. We have created a list of tips for helping with your screening here. If you’re taking testosterone, there is some evidence that it can affect how easy it is to get a viable sample for testing. Testosterone can also cause some cell changes on the cervix that may result in you being referred for a colposcopy appointment to take a closer look at your cervix. Don’t worry if you have got an abnormal result, this does not mean you have cancer. If you have any worries or concerns about going for your screening, do speak to your nurse, doctor or our Ask Eve information service.

Not everyone who is intersex will need a cervical screening test. You only need a cervical screening test if you have a cervix.

Your nurse or doctor will want to make you feel comfortable and reassured during this procedure, and good communication between the two of you is really important. Take your time, ask the questions you need answers to in order to feel as in control and relaxed as possible. Our tips on screening for trans men, non-binary and intersex people with a cervix can be found here, and our Ask Eve information service team are here to help you.

Yes. The HPV vaccine available on the NHS works against nine strains of HPV: 6, 11, 16, 18, 31, 33, 45, 52 and 58. Types 16 and 18 cause around 7 out of 10 cervical cancers. There are five other strains of high-risk HPV (HPV that can cause cervical cell changes) that are not currently included in the vaccination. Together, the vaccination (typically given to children age 12-13, but available to trans people up until the age of 45 in sexual health clinics) and screening programme in the UK prevent thousands of cases of cervical cancer a year. We encourage people to have both the vaccine and regular screening tests if they’re eligible.

HPV can be transmitted through any skin-to-skin contact that involves the genitals, this includes mutual masturbation, oral, vaginal or anal sex and the sharing of sex toys. So it is important to attend your cervical screening test when invited, even if you have not had penetrative sex.