What, why and how a cervical smear test could save your life.
By Claire Chamberlain
Before we start, let’s get one thing clear: no-one enjoys having a smear test. On the scale of ‘Procedures We Would Rather Avoid’, it’s probably nestled somewhere between treating a fungal nail infection and a trip to the dentist: worse than having to admit you don’t keep your feet clean, but not as bad as, say, root canal surgery.
But nonetheless, attending your cervical screening appointment every three years is essential for women aged 25 to 64. Here’s why:
Why is cervical screening so important?
There are roughly 3,200 cases of cervical cancer diagnosed each year and almost 900 women die from it annually. Yet despite regular screening offered to all women aged 25 to 64, one in four women skip screening.
While a smear test doesn’t actually hurt (more on that later), it seems the thing that can make it utterly excruciating is embarrassment.
35% of women report they are embarrassed to attend their smear test because of their body shape.
A worrying survey, carried out at the start of the year by Jo’s Cervical Cancer Trust, found 35 per cent of all women report they are too embarrassed to attend their smear test because of their body shape.
We understand it’s not pleasant to expose your bits to a medical professional, but (and this is the important bit): a smear test could save your life. So, if you’re at all embarrassed or concerned about the screening process, read on to find out why it’s so important and what it involves… then book your appointment today!
We spoke to Mr Joseph Yazbek, consultant gynaecologist and gynaecological oncology surgeon at King Edward VII’s Hospital about what to expect:
Cervical screening explained
Cervical screening is something many women fear, thinking it’s embarrassing, invasive, uncomfortable and painful. However, it’s actually a very straightforward procedure that lasts around five minutes, and it could potentially be a life saver – it’s estimated that, in the UK, 2,000 lives are saved each year by cervical screening.
It’s estimated that, in the UK, 2,000 lives are saved each year by smear testing.
It’s normal to feel embarrassed, but your nurse or doctor will have performed many smear tests in the past, and they will help you feel relaxed and reassured.
How often should you get tested?
In the UK, women (and trans men who still have a cervix) aged 25 to 49 are invited for cervical screening every three years, and those aged 50 to 64 are invited every five years. Those over 65 will only be invited for cervical screening if they have had an abnormal test result from a recent smear test.
How to prepare for cervical screening
When you are invited to have a cervical screening test, you should aim to book your appointment for when you are not on your period. The ideal time is in the middle of your cycle – around 14 days after the start of your last period.
? During your cervical screening you can ask to be seen by a female nurse or doctor test if you prefer.
Avoid using condoms with spermicides or other oil-based lubricants 24 hours before your smear test, as these can interfere with the results and could mean you have to have the test again.
What happens during cervical screening
Cervical screening is usually carried out by a healthcare professional, such as a nurse or a doctor (GP or gynaecologist). The whole procedure will take no more than five minutes and the actual test will take two minutes. Here’s what to expect:
✔️ When you arrive, you will be asked to go behind a curtain or screen to undress from the waist down.
✔️ You will then need to lie on your back on an examination bed, with your feet flat on the bed and your knees up.
✔️ You will be able to cover your bottom half with a large paper towel.
✔️ The examiner will then gently place an instrument called a speculum into your vagina. A speculum is usually made from plastic or metal, and will be clean and sterile.
✔️ It may feel cold, and your examiner may use a water-based lubricant to help guide the speculum into your vagina.
✔️ The speculum holds open the walls of your vagina and allows visualistion of your cervix. Sometimes you will need to move your bottom around a little bit, in order for your cervix to come into view.
✔️ A small, soft, flexible, plastic brush will be passed into your vagina to sweep it over your cervix. This collects a sample of cervical cells.
✔️ The top of the brush containing the cervical cells will be dipped a few times into a pot of fluid. The pot will be sealed with a lid and labelled with your name.
✔️ The speculum will be carefully removed from your vagina.
✔️ You can then get dressed. If a lubricant was used, you can use a tissue to wipe away any excess.
✔️ Your sample will then be sent to a laboratory for testing and you will receive your results within two weeks.
Does cervical screening hurt?
For some women, a cervical screening test feels a little uncomfortable. You may experience a small, period-like cramp as the brush sweeps across your cervix. You may also bleed a tiny bit afterwards.
If you feel more than a little uncomfortable, it’s important to tell your nurse or doctor.
If you feel more than a little uncomfortable, it’s important to tell your nurse or doctor. Either way, being relaxed will help.
Feeling stressed will cause the muscles in your legs and pelvis to become tense, which can make the test more difficult.
Your examiner will tell you when they are about to perform each stage of the test, and may ask you to take a few slow, deep breaths.
What does the laboratory test for?
The laboratory will look for abnormal cervical cells. This is called cytology. If they find abnormal or borderline cells, they will also look for the presence of HPV. Some laboratories automatically look for both, regardless of whether they find abnormal cells or not.
Cervical screening is not 100 per cent accurate. The cytology part is around 70-80 per cent accurate and the HPV testing part is around 90-95 per cent accurate. But it is still the best way to know if you have abnormal cells in your cervix.
How will I get my test results?
You will be posted a copy of your results, and so will your GP surgery or clinic.
- Normal results:If your results are normal, it means no abnormal cells were found.
- Inadequate results: An ‘inadequate’ result means the sample did not contain enough cervical cells. It could also mean you have a yeast or bacterial infection present that masked the cells, making them difficult to view.
Your doctor or nurse can advise you on what to do next, and when you can book a repeat cervical screening test.
What if my results are abnormal?
An abnormal cervical screening result does not mean that you have cervical cancer. It means that you have abnormal cells, which could lead to cancer in the future.
Your doctor will talk to you about your options. Sometimes treatment is offered to remove the abnormal cells to prevent them from developing into cancer. Other times, the abnormal cells will go back to normal by themselves. You may be offered more regular cervical screening tests to check this.