The smear test: what is it and how does it work?

In the UK, every woman or person with a cervix aged 25 to 64 receives an invitation for cervical screening (smear test) every couple of years. What do they check for, how does it work, and why is it done on such a large scale? 

What is a smear test?

During a smear test, a small sample of cells will be taken from the cervix. These cells are then tested for HPV (human papillomavirus), which can cause cervical cancer. The goal of cervical screening is to check for certain types of HPV in order to prevent them from turning into cancer. If found early, HPV is easy to treat. If your smear test shows the presence of HPV, the sample is then checked for changes in the cells of the cervix. Many people get this virus at least once in their life, but your body often gets rid of it within a couple of years. You usually get the results from your smear test by letter within 2 weeks.

How does it work?

You will be invited for cervical screening by letter every 3 (age 25 to 49) to 5 years (age 50 to 64). When you make an appointment, it’s good to know what to expect. We will explain the process step by step.

Step 1: making an appointment

As soon as you get a letter, you can make an appointment with your GP. The letter will give you all the information you need to know on how and where to make an appointment. The test is usually done by a female doctor or nurse and takes about 5 minutes.

Step 2: undress

You will need to undress from the waist down. You can do this behind a screen and the doctor or nurse will give you a sheet to put over you. They will ask you to lie back on a bed with your knees pulled up and your legs spread. Tip: wear a skirt or dress, so you can easily pull up it up or down during the appointment. Bring someone with you if that makes you feel more comfortable. Keep in mind that you’re in control and that you can ask the nurse or doctor to stop at any time.

Stap 3: the test

In order to reach the cervix, the doctor or nurse will put a speculum into your vagina and open it. They might use some lubricant during insertion. They will then take a sample of cells from your cervix with a soft brush. This can feel a little uncomfortable, so try to relax as much as possible. Doing some breathing excercises can be helpful. After taking the sample, the doctor or nurse will close the speculum and remove it. They will then leave you alone so you can get dressed. You might notice some spotting or light bleeding after your smear test. This is normal and should go away after a couple of hours.

Step 4: the results

The results are usually sent to you in a letter. The nurse or doctor who does your cervical screening will tell you when to expect it. If you don’t receive your letter in the expected time frame, call your GP to ask for an update. Try not to worry if it takes a long time before your letter arrives, as this isn’t related to the results. There are a couple of possible results:

• HPV is not found in your sample. This is the most common result. Your risk of getting cervical cancer is very low and no further testing is necessary. You will receive an invitation for the next screening in 3 or 5 years.
• HPV has been found in your sample, but there are no abnormal cells. You will need to be tested again in 1 year and again in 2 years if HPV is still present in your cervix. If you still have HPV after 3 years, you may need to have a colposcopy.
• HPV has been found in your sample and you will need to have a colposcopy. A colposcopy is largely the same as a cervical screening, but it is done in hospital. During the procedure, a doctor will examine your cervix. A colposcopy is done to confirm whether there are abnormal cells in your cervix and whether you will need treatment to remove these cells. The procedure takes about 15 to 20 minutes. The doctor will insert a speculum and will inspect your cervix with a microscope with a light (which won’t enter your body). They will apply liquids to your cervix to highlight abnormal areas. They might also take a small sample of tissue for examination in a laboratory.

Should I make an appointment?

Cervical screening is one of the best ways to prevent cervical cancer. However, cervical screening is a choice. You don’t have to make an appointment if you don’t want to for any reason. If you don’t want to be invited in the future, you can call your GP and ask them to take your name off their cervical screening list. If you need treatment after your smear test, there are some risks, like bleeding/getting an infection or treating cells that would have gone back to normal on their own. If you have any questions about anything, contact your GP. If you’re afraid of getting tested because of privacy reasons, religion, or sexual trauma, contact your GP as well. They can help and reassure you and give you advice.

What to do if I experience problems?

Always contact your GP if you experience discomforts that could be related to cervical cancer, such as sudden blood loss or changes in your vaginal discharge. Don’t wait for your cervical screening invitation in this case and contact your GP as soon as possible.