Cervical Screening FAQs

We understand that cervical screening appointments can be difficult for some people, and that if you are a trans man, someone who is intersex or identifies as non-binary, there are additional barriers that might prevent you from having your test. Everyone with a cervix should be able to access the NHS cervical screening programme, and we want to provide helpful information for every community. Here we have answered some frequently asked questions:

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 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, but at the age of 25 you can contact your GP, or specialist clinic, and book your screening test.

You will be eligible for your next screening test every three years until the age of 50, and then every five years until the age of 64, if your screening tests are normal.

Although you will no longer receive screening invitations after the age of 64 as the risk of developing cervical cancer is low, you can still request cervical screening.

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 protect against cervical cancer. This is because it can detect precancerous changes to the cells of the cervix, which if left untreated, could potentially develop into cervical cancer in the future. These changes give no symptoms which is why it is important to attend for screening. Please don’t be scared that this is a cancer test, it is designed to be preventative and reduce your risk.

The doctor or nurse will take a sample of cells from your cervix. They will do this by inserting a speculum (small plastic instrument) into the vagina, which holds the vaginal walls apart and allows the nurse or doctor to clearly see your cervix. They will then sweep the cervix with a soft plastic brush to collect the cells. Your sample will be sent to a laboratory for testing, where they will look first of all for high-risk HPV (human papillomavirus), a virus that causes almost all cervical cell changes. If high-risk HPV is present, your cells will then be tested for any abnormalities. It is important to remember that most people who have high-risk HPV will not have any cervical cell changes.

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 mild, moderate or severe dyskaryosis.

Will the cervical screening test hurt?

For some people, a cervical screening test can be uncomfortable. If you’re someone who doesn’t typically experience vaginal penetration, then there may be a higher chance of an internal examination causing you some discomfort.

If you are taking an oestrogen suppressant i.e. something that is stopping your ovaries from oestrogen, you will have less natural lubrication.

Using a natural vaginal moisturiser before your appointment will help to make the screening test more comfortable, and asking the doctor or nurse to use the smallest speculum can help minimise discomfort.

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

Anyone with a cervix is at risk of developing cervical cancer. If you are a trans man who has a 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 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 have any worries or concerns about going for your screening, do speak to your nurse, doctor or our Ask Eve information service.

I am a non-binary, 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 we encourage you to attend your cervical screening appointment. This can understandably be something that is difficult to navigate, but your nurse and doctor are there to help you make the experience as positive as possible. Speak to them beforehand, go through what the appointment will involve and do check our list of tips on cervical screening, HERE. If you have any worries or concerns about going for your screening, do speak to your nurse, doctor or our Ask Eve information service.

I am intersex, do I need to go for a cervical screening test?

Not everyone who is intersex will need a cervical screening test. If you are intersex, it will depend on your combination of internal reproductive organs, i.e. whether or not you have a cervix, as to whether or not you need the screening test.

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.

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

Yes. The HPV vaccine available on the NHS works against four strains of HPV: 6, 11, 16 and 18. Types 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. It is still important to go for your screening test to pick up on any abnormal changes to your cervix. Together, the vaccination (typically given to children age 12-13) 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 applicable to you.

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

If you have never had penetrative 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, so we would still recommend that you attend your screening appointment.

Jo’s Cervical Cancer Trust also has information and advice on their website which you might find helpful.