Screening for cervical cancer

Cervical screening is a test to check the health of your cervix, which is the entrance to the womb from the vagina. Cervical screening is sometimes known as a smear test.

Cervical screening is not a test to detect cancer, but rather a test to prevent cancer. Cervical screening can spot changes to the cells in the cervix before cancer has developed and remove these cells before they have the chance to develop into cancer.

The cervical screening test takes a small sample of cells from the cervix to look for signs of the human papillomavirus (HPV), which causes almost all cases of cervical cancer. If HPV is found, then the same sample of cells from the cervix are inspected for any pre-cancerous changes.

If you have any questions about cervical screening speak to your GP surgery.

The NHS invites all women and people with a cervix aged 25 to 64 for a cervical screening appointment. If you are 65 or older, you will only be automatically invited for screening if one of your last three tests was abnormal, but you can still receive screening by making an appointment through your GP if you have never been for cervical screening, or have not been since the age of 50.

Trans men and/or non-binary people with a cervix are also eligible for cervical screening. Ajustments can be made to make the appointment as comfortable as possible.

Children aged 12 and 13 are offered a HPV vaccine to protect from up to nine strains of HPV including two types which cause 7 in every 10 cases of cervical cancer.

Even if you’ve had the HPV vaccine, it is still important to attend screening as you can still be at risk of developing cervical cancer.

During your appointment, you will be asked to undress from the waist down, and lie on a bed with your knees bent. The nurse will place a plastic instrument called a speculum into your vagina so that they can see the cervix clearly. They will then use a soft brush to collect a small sample of cells from your cervix, and then the speculum will be removed. The sample of cells will be sent to a laboratory for testing, to check for signs of HPV.

The screening process usually lasts about 5 minutes, with the whole appointment taking no longer than 10 minutes.

For most people, cervical screening feels uncomfortable or a little strange, but shouldn’t be painful. However, some women do find that it hurts, particularly if they have pre-existing medical conditions which affect the cervix or vagina.

Tell the nurse or doctor performing the test if you have any concerns about pain or pre-existing conditions. Adjustments can be made, such as the use of a smaller speculum, or laying in a different position.

For most people, the result will be ‘HPV negative’. This means HPV was not found in your sample, and you will be invited back for screening in three or five years as normal.

If high-risk HPV is found, the laboratory will look again at your sample for any changes to the cells of your cervix. If abnormal changes are detected, you will be invited back for further tests. Not all cell changes develop into cervical cancer, but it is important to monitor these changes and treat them if needed.

If there are no abnormal changes, you will be invited to a screening appointment a year later to check if the HPV has gone.

Your nurse or doctor who does the test will tell you when you can expect your results. These will arrive to your home in the post. If you have waited longer than expected call your GP surgery. Your letter will explain what was tested for and what your results mean.

There was some disruption to cervical screening at the beginning of the pandemic, but the NHS worked very hard to restart the screening programmes and have been sending out invitations since summer 2020. GP surgeries have put extra precautions in place to make sure your risk of COVID 19 is low, including:

• Staggering appointments to ensure social distancing and thorough cleaning inbetween patients.
• Social distancing measures in the waiting room.
• Use of protective equipment including apron, gloves and mask

Therefore, if you receive your invitation letter, don’t delay in making an appointment. If you think you have missed a screening appointment, contact your GP.

Cervical screening is one of the best ways to protect yourself from cervical cancer, but it is also important to understand the risks:

• You may have some light bleeding or spotting after cervical screening, though this should stop within a few hours.

• There is the possibility that cell changes may be missed, this is called a false negative result. It is therefore important to be aware of the symptoms of cervical cancer and see your GP if you notice anything unusual.
• If abnormal cells are found and treated, there is the risk that these cells may have gone back to normal on their own without treatment. Treatment can sometimes cause bleeding and infection, and you may be more likely to have a baby early if you get pregnant in the future, but this is rare.

Despite these small risks, Yorkshire Cancer Research recommends that eligible women and people with a cervix attend their cervical screening. The programme is designed to save lives and is recognised for its success. Without it, more women and people with a cervix would develop and die of cervical cancer each year.

Source: Cervical screening - why it's important

Advice for trans men or non-binary people assigned female at birth

If you have had an operation to remove your womb and cervix (full hysterectomy), you no longer need to attend cervical screening. If you have not undergone full hysterectomy, you should consider attending cervical screening. We recommend letting the nurse taking the sample know if you are taking testosterone and whether you are still having menstrual periods to help make sure that the result is accurate. You can also ask for changes such as a smaller speculum, or ask to insert it yourself, to reduce discomfort.

• If you are registered with your GP as female
  You will be invited for cervical screening. If you have had a full hysterectomy or would not like to be invited for screening, you can contact your GP to be taken off their cervical screening list.
  
  
• If you are registered with your GP as male
  You will not be invited for cervical screening. If you have not had a full hysterectomy and would like to attend cervical screening, you can contact your GP for an appointment.

Some clinics specialise in services for trans and non-binary people. Ask your GP or gender identity clinic if you would like to know where your nearest specialist clinic is.

Advice for trans women or non-binary people assigned male at birth

Trans women and non-binary people assigned male at birth do not have a cervix, so do not need to attend cervical screening.

• If you are registered with your GP as female
  You will be invited for cervical screening. You can contact your GP to be taken off their cervical screening list.
  
• If you are registered with your GP as male
  You will not be invited for cervical screening.