Cervical Screening

What is cervical screening?

• All women aged 25 to 64 are invited for cervical screening every 5 years to check the health of their cervix. Cervical screening used to be called a smear test.
• Everyone with a cervix should go for cervical screening.
• If you're a trans man or non-binary and have a cervix, you can speak to your GP, sexual health clinic or transgender health clinic about getting invitations routinely.
• The cervix is the opening to your womb from your vagina.
• It's not a test for cancer, it's a test to help prevent cancer.
• During the screening appointment, a small sample of cells will be taken from your cervix.
• The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called high risk types of HPV.
• If these types of HPV are not found, you do not need any further tests.
• If these types of HPV are found, the sample is checked for any changes in the cells of your cervix. These can be treated to help prevent cervical cancer.
• The nurse or doctor will tell you when you can expect your results.

Why cervical screening is done

Try not to put off cervical screening. It's one of the best ways to protect yourself from cervical cancer.

How cervical screening helps prevent cancer

Cervical screening is not a test for cancer, it's a test to help prevent cancer. It checks a sample of cells from your cervix for high risk types of human papillomavirus (HPV).

High risk HPV can cause abnormal changes to the cells in your cervix.

If high risk types of HPV are found during screening, the sample of cells is also checked for abnormal cell changes.

If abnormal cells are found, they can be treated to help prevent cervical cancer.

What HPV is

HPV is the name for a very common group of viruses.

Most people will get some type of HPV during their lives. It's very common and nothing to feel ashamed or embarrassed about. Some high risk types of HPV can cause certain types of cancer, including cervical cancer.

You can get HPV from any kind of skin-to-skin contact of the genital area, not just from penetrative sex.

This includes:

• vaginal, oral or anal sex
• any skin-to-skin contact of the genital area
• sharing sex toys

In most cases your body will get rid of HPV without it causing any problems. But sometimes HPV can stay in your body for a long time.

If high risk types of HPV stay in your body, they can cause changes to the cells in your cervix. These changes may become cervical cancer if not treated.

If you do not have a high risk type of HPV it's very unlikely you'll get cervical cancer, even if you've had abnormal cell changes in your cervix before.

Find out more about what HPV is

Who's at risk of cervical cancer

If you have a cervix and have had any kind of sexual contact, with a man or a woman, you could get cervical cancer. This is because nearly all cervical cancers are caused by infection with high risk types of HPV.

Find out more about the causes of cervical cancer

You're still at risk of cervical cancer if:

• you've had the HPV vaccine – it does not protect you from all types of HPV, so you're still at risk of cervical cancer
• you've only had 1 sexual partner – you can get HPV the first time you're sexually active
• you've had the same partner or not had sex for a long time – you can have HPV for a long time without knowing it
• you're a lesbian or bisexual – you're at risk if you've had any sexual contact
• you're a trans man with a cervix
• you've had a partial hysterectomy that did not remove all of your cervix

If you're not sure whether to have cervical screening, talk to your GP or nurse.

If you've never had any kind of sexual contact with a man or woman, you may decide not to go for cervical screening when you're invited. But you can still have a test if you want to.

When you'll be invited for cervical screening

Who cervical screening is for

All women and people with a cervix between the ages of 25 and 64 should go for regular cervical screening.

You'll be invited for screening every 5 years from when you're 25 to 64 years old. You'll get your first invitation a few months before you turn 25.

You may be invited more regularly if you have HPV.

If you're 65 or older, you'll only be invited if a recent test was abnormal.

You'll get an invitation through the NHS App, by text or by letter asking you to make an appointment and telling you how to book.

You can book an appointment as soon as you get an invitation.

If you missed your last cervical screening, you do not need to wait for an invitation to book an appointment.

If you're trans or non-binary

If you're a trans man or are non-binary and have a cervix, how you're invited depends on the sex you're registered with at a GP surgery.

• If you're registered as female with a GP, you'll automatically be invited for cervical screening.
• If you're registered as anything other than female, such as male or indeterminate, you may not be invited for cervical screening automatically – speak to your GP surgery, sexual health service, or transgender health clinic and ask to get invitations automatically.

If you're a trans woman or are non-binary and do not have a cervix, you do not need to have cervical screening. But, if you're registered with a GP as female, you may still be invited. Contact your GP surgery, sexual health service or transgender health clinic and ask to stop being invited.

Find out more about population screening for trans and non-binary people on GOV.UK

When cervical screening is not recommended

If you're under 25

You will not be invited for cervical screening until you're 25 because:

• cervical cancer is very rare in people under 25
• it might mean you have treatment you do not need – abnormal cell changes often go back to normal in younger women

If you're 65 or older

You'll usually stop being invited for screening once you turn 65. This is because it's very unlikely that you'll get cervical cancer if your recent tests did not find anything.

You'll only be invited again if a recent test was abnormal.

If you're 65 or older and have never been for cervical screening, or have not had cervical screening since the age of 50, you can ask your GP for a test.

If you've had a total hysterectomy

You will not need to go for cervical screening if you've had a total hysterectomy to remove all of your womb and cervix.

You should not receive any more screening invitations.

What happens at your cervical screening appointment

Cervical screening involves taking a small sample of cells from your cervix for testing. It's usually done by a female nurse or doctor, who will explain the test and answer any questions you have before they start.

How cervical screening is done

1. You'll need to undress, behind a screen, from the waist down. You'll be given a sheet to put over you.
2. The nurse or doctor will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart. Sometimes you may need to change position during the test.
3. They'll gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant may be used.
4. The nurse or doctor will open the speculum so they can see your cervix.
5. Using a soft brush, they'll take a small sample of cells from your cervix.
6. The nurse or doctor will close and remove the speculum and leave you to get dressed.

The cervical screening test itself should take less than 5 minutes. The whole appointment should take about 10 minutes.

Preparing for your cervical screening test

If you're worried about cervical screening, there are things you can try that might make the test easier for you.

Do

• wear something you can leave on during the test, like a skirt or long jumper

• bring someone with you for support

• try breathing exercises to help you relax – ask the nurse or doctor about these

• ask the nurse or doctor to use a smaller speculum if you feel any discomfort

• ask if you can put the speculum in yourself if you would prefer to

• ask about lying in a different position – such as on your side with your knees pulled up to your chest

• bring something to listen to or read during the test

Don’t

• do not feel pressured to keep going – you can ask to stop the test at any time

• try not to be afraid or embarrassed to talk to the nurse or doctor – telling them how you feel will help them understand what kind of support you might need

Risks of cervical screening

You may have some light bleeding or spotting after cervical screening. This should stop within a few hours.

Your cervical screening results

Your cervical screening results are usually sent to you by letter. Sometimes you may be asked to call your GP to get the results.

When your cervical screening results should arrive

The nurse or doctor will tell you when you can expect your results.

If you've waited longer than you expected, call your GP surgery to see if they have any updates.

Try not to worry if it's taking longer than expected to get your results.

It does not mean anything is wrong, and most people will have a normal result.

What your cervical screening results mean

Your cervical screening results will explain if human papillomavirus (HPV) was found in your sample, what your result means, and what happens next.

HPV is not found in your sample

Most people will not have HPV (an HPV negative result).

This means your risk of getting cervical cancer is very low. You do not need any further tests to check for abnormal cell changes in your cervix, even if you've had these in the past.

You'll be invited for screening again in 5 years.

An unclear result

Sometimes you'll be asked to come back in 3 months to have the test again. This does not mean there's anything wrong, it's because the results were unclear. This is sometimes called an inadequate result.

HPV is found in your sample

Your results will explain what will happen next if HPV is found in your sample (an HPV positive result).

There are 2 different kinds of HPV positive result.

The 2 possible HPV positive results and what they mean

Result	What it means
HPV found (HPV positive), but no abnormal cell changes	You'll be invited for screening in 1 year and again 1 year later if you still have HPV. If you still have HPV after 2 years, you'll be asked to have a colposcopy.
HPV found (HPV positive) and abnormal cell changes	You'll be asked to have a different test, called a colposcopy, to look at your cervix.

 

If you need a colposcopy

A colposcopy is a simple procedure to look at your cervix.

It's similar to having cervical screening, but it's done in hospital.

You might need a colposcopy if your cervical screening results show you have HPV and abnormal changes to the cells of your cervix.

Find out more about having a colposcopy

Try not to worry if you've been referred for a colposcopy.

Any changes to your cells will not get worse while you're waiting for your appointment.

Further help and support for cervical screening

Getting support with cervical screening

You may need more help and support with cervical screening for many reasons.

Speak to your GP surgery if you have questions about cervical screening invitations, results or any symptoms you have.

Support for everyone

For more information and support about going for cervical screening, you can contact The Eve Appeal by:

• Helpline: 0808 802 0019
• Ask Eve Nurse Information Service

There's also information on GOV.UK for people who feel anxious about attending cervical screening.

Support for LGBTQ+ people

• Cervical screening: information for trans men, non-binary and intersex people with a cervix from The Eve Appeal
• Cervical screening for lesbian and bisexual women on GOV.UK
• Cervical screening for trans and non-binary people on GOV.UK

Support for people with vulval pain

• Guide to making a speculum examination more comfortable from the Vulval Pain Society

Support for people with a learning disability

• Easy read guide to cervical screening on GOV.UK
• Easy read guide to cervical screening from The Eve Appeal (EXTERNAL PDF LINK)

Support after sexual violence

If you've experienced sexual violence, you may find the idea of cervical screening very difficult.

The My Body Back Project gives support after sexual violence by running My Body Back screening clinics for people who have experienced sexual violence.