In this blog post, we answer your questions about cervical screening, how it has been affected by the COVID-19 pandemic, and what Yorkshire Cancer Research is doing to increase participation in screening.
What is cervical screening?
Who is invited for cervical screening?
How often will I be invited for cervical screening?
Why should I attend my appointment if invited?
What happens during a cervical screening appointment?
Does cervical screening hurt?
What could the results of screening be?
What effect has the COVID-19 pandemic had on cervical screening? Can I still take part?
Why is cervical screening important in Yorkshire?
What is Yorkshire Cancer Research doing to improve cervical screening?
Cervical screening is sometimes known as a smear test. It is a test to check the health of your cervix, which is the entrance to the womb from the vagina.
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 cells from the cervix are inspected for any pre-cancerous changes.
Cervical screening is not a test to detect cancer, but rather a test to prevent cancer. If any abnormal changes are found during cervical screening, they can be treated or removed before they turn into cancer.
The NHS invites all women 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.
You will be invited every three years between the ages of 25 to 49, and every five years up to the age of 64.
Cervical screening can help stop you developing cervical cancer. Spotting abnormal changes and treating them early could save your life.
Children aged 12 and 13 are offered a HPV vaccine to protect from two types of HPV which cause seven in every 10 cases of cervical cancer. But 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 performing the test if you have any concerns about pain or pre-existing conditions.
For most people, the result will be ‘HPV negative’. This means no HPV was 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. If there are no abnormal changes, you will be invited to a screening appointment a year later to check if the HPV has gone.
The COVID-19 pandemic has disrupted cervical screening. However, since summer 2020, GP surgeries have been inviting people to take part with additional COVID precautions in place. Therefore, you can (and should) still attend your cervical screening appointment if invited. If you think you have missed an appointment, speak to your GP. Even if your GP surgery cannot offer cervical screening straight away, don’t delay when you do get invited.
Around 280 cases of cervical cancer were diagnosed in Yorkshire during 2018. Nearly one million women in Yorkshire are up to date with their cervical screening.
74% of women eligible for screening attended a regular appointment when invited. Although this is slightly above the average for England as a whole (72%), it means around 1 in 4 women in Yorkshire do not attend screening when invited.
In addition, there’s a wide variation in attendance across Yorkshire, particularly in women aged 25 to 49. In Bradford, of women aged 25-49 invited, just 69% attended an appointment, whereas in East Riding of Yorkshire the figure was 79%. In some GP practice areas, as few as 2 in 10 women attended their cervical screening appointment.
We encourage everyone to book a cervical screening appointment when invited. Yorkshire Cancer Research is funding two programmes to improve participation in all cancer screening, including cervical screening. Local programmes can identify the reasons why people don’t attend screening appointments and address these issues with specific and targeted approaches.
Wise Up To Cancer is a programme supported by Yorkshire Cancer Research in Wakefield, in partnership with Wakefield Council, NHS Wakefield CCG and the Wakefield Health Alliance. We’re working with 16 GP practices where participation in cancer screening is low to find ways to help improve screening rates. This includes specially trained ‘cancer facilitators’ who help GP practices identify and contact people who have not taken up an invitation for screening.
Cancer Wise Leeds is another programme to improve screening. It is funded by Yorkshire Cancer Research and delivered in partnership with the Leeds Cancer Programme. The programme involves a team of ‘cancer screening and awareness coordinators’, whose aim is to use a variety of different methods to help GP practices across the city improve participation in cancer screening. This has led to improvements in how cervical screening is delivered, including offering more screening appointments outside of standard GP practice opening hours.