Facts and Tips for Cervical Screening

In our 'Myths and Truths' series for Cervical Screening Awareness Week, we are answering all of your questions around cervical screening and what you can expect if you have an abnormal result. So get clued up and get booked in!

When am I due to go for my first cervical screening?

Cervical screening (also known as a smear test) begins at the age of 25 in the UK. Around the time of your 25th birthday you will receive a letter inviting you to book your first screening appointment. You can then contact your GP to book in your test.

You will be sent a letter to invite you for your screening every three years until the age of 50, and then every five years until the age of 64. However, these appointments will be more frequent if any abnormalities are picked up, or if you have an increased risk of cervical cancer.

Despite reminder letters stopping at 64, due to the low risk of developing cervical cancer after this age, cervical screening appointments can be accessed at any age over 25. If you are 65 or over and feel you would benefit from a cervical screening appointment, please contact your GP.

What is a cervical screening test and how does it work?

The cervical screening programme is designed to pick up any precancerous changes to the cells of the cervix. It is not a diagnostic test for cervical cancer.

The doctor or nurse will take a sample of cells from your cervix. They will do this by inserting a speculum into the vagina and sweeping the cervix with a soft plastic brush to collect the cells. Your sample will then be sent off for testing. They will be looking to see if you have Human Papilloma Virus (HPV), if you do have HPV, your sample will be checked for any changes to the cells which could potentially lead to cervical cancer in the future.

HPV is a common virus passed on through skin to skin sexual contact that causes over 99% of all cervical abnormalities. Your changes will be categorised into Cervical Intraepithelial Neoplasia (CIN) 1 (low grade), CIN2 (medium grade) or CIN3 (high grade).

Will the cervical screening test hurt?

The cervical screening test can cause some discomfort for some people, but it should not be painful. If you have a medical condition which is likely to cause you pain whilst having your cervical screen, such as vaginismus or lichen sclerosus, do talk to your GP beforehand and voice your concerns. There are very few people who are unable to have a cervical screening test at all due to medical reasons, and there are ways in which your doctor or nurse can adapt your test to make it more comfortable for you, such as using a smaller speculum.

I’m trans. Do I need to go for a cervical screening test?

If you have a cervix, you will still be at risk of cervical cancer and do need to attend your cervical screening appointment. If you have any worries or concerns about going for your screening, do speak to your GP or our Ask Eve nurse service. We have more information for trans men, non-binary and intersex people on cervical screening, including top tips to help with your appointment, which you can read HERE.

I am a woman who has only had sex with women, do I need a cervical screening test?

Yes you do. Unlike other STI’s, it is transmitted by skin to skin contact and can be anywhere, including your fingers and mouth. You can have HPV from just one sexual experience, and do not need to have had penetrative sex.

I have had a gynaecological cancer (not cervical) in the past, do I need to be screened?

Depending on what cancer treatment you went through, you may or may not need to go for your cervical screening. If you still have a cervix, it is likely that you do. Your GP or cancer specialist will be able to advise you on this.

I am on my period, can I still go for my screening test?

Yes you can. Being on your period should make no difference to getting your screening test done. If you feel uncomfortable and would prefer to change the date of your appointment, get in touch with your GP.

I have had the HPV vaccine, do I need my screening test?

Yes. The current HPV vaccine works against four strains of HPV: 6, 11, 16 and 18. Strands 16 and 18 cause around 70% of all cervical cancers. There are 11 other strains of high-risk HPV (HPV that can cause precancerous abnormalities) that are not currently included in the vaccination. As well as this, not all cervical cancers are caused by HPV (although over 99% are). It is still important to go for your screening test to pick up on any abnormal changes to your cervix. Together, the vaccination and screening programme in the UK prevent thousands of cases of cervical cancer a year, so it is important to have both if applicable to you.

I haven’t had sex. Do I need to go for my screening test?

If you have never had sex, it is not a guarantee that you do not have any cervical abnormalities. Remember that sexual contact, without full intercourse can still transmit HPV.  If you have never had any type of sexual contact then you are at a lower risk of cervical cancer, but as a small number of cervical cancers are not caused by HPV, it is important to still go for your screening test.

I am worried screening will be difficult for me as I am a survivor of sexual trauma.

Cervical screening may be difficult if you have trauma that may be triggered during the procedure. There are some things which you can do which may help make the experience a bit easier. Remember, you are in control of the situation, and you can ask the doctor or nurse to stop at any time for any reason. If you can, talk to your doctor or nurse and let them know that you have a trauma history if you are able to, sometimes writing it down may be easier, that way they will be aware and can help make the process easier.

Some other things which may help are relaxation/breathing techniques, making an appointment to discuss the screening beforehand so you can meet the nurse and talk through the process, taking music/earphones/audiobooks, asking for the smallest sized speculum, and putting it in yourself if that would help. Wearing clothes that are comfy, a long skirt will enable you to have the procedure and leave your skirt on. There is no expectation to go through with the test on the first appointment, and it is okay to try again at a later date, or decide that screening is not something you are able to do.

I have vaginal atrophy and am worried about going for my cervical screening test.

Vaginal atrophy means that due to a lack of oestrogen, the walls of the vagina have become thinner, dry and inflamed. This skin condition can affect people of any age but is most common in those who are post-menopausal, due to the significant drop in oestrogen levels. Vaginal atrophy can be treated with over the counter vaginal moisturisers (different from a lubricant) and for some women, doctors may prescribe an oestrogen based cream that can be applied directly to the affected area. Using the smallest speculum available will also minimise discomfort when someone with vaginal atrophy has their cervical screening test. Communicating with the healthcare professional carrying out the test is important. At the start of appointment, explain that you have vaginal atrophy, will need the smaller speculum, and just make him/her aware of your concerns.

I have Lichen Sclerosus, what does this mean for me in terms of cervical screening?

Lichen Sclerosus is a chronic inflammatory skin condition that can affect any part of the body, but most often the genitals. For some women and people with a vulva having LS will cause no issue at all regarding cervical screening, but for others, the scar tissue that can form around the vulva and vaginal opening can be an issue when it comes to inserting a speculum. Like with vaginal atrophy, applying vaginal moisturisers and using the smallest speculum are helpful and if possible, perhaps booking a double appointment to talk through your needs, risks and options.

If you have questions about what might happen next with the results from your cervical screen, check out our answers to your questions about cervical precancerous treatment.