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Cervical screening

Published by Bupa's health information team, September 2009.

This factsheet is for women who would like information about having a cervical smear test for screening. This means having the test when you don't have any symptoms.

A cervical smear is a test to check the health of the cervix (the neck of the womb). The test checks for changes in the cells of the cervix that may, if untreated, develop into cervical cancer. Catching the changes early means that cervical cancer can be prevented.

What is a cervical smear test?
Deciding on cervical screening
About the procedure
Getting your results
Questions and answers
Related topics
Related Bupa products and services
Further information
Sources

What is a cervical smear test?

A cervical smear test is a technique used to detect potentially cancerous changes in the cells of your cervix (the neck of your womb). These changes can be detected by a laboratory test on a small sample of cells taken from an area on the surface of your cervix called the transformation zone.

Where cervical cancer cells can be found

The National Health Service (NHS) runs a cervical screening programme in the UK.

The NHS cervical screening programme aims to screen all women aged between 25 and 49 every three years, and women aged 50 to 64 every five years. Cervical cancer is very rare in women under 25 and unlikely to develop in women over 64.

Cervical screening is carried out in a GP surgery by a GP or practice nurse or at a community clinic, such as a family planning or well-woman clinic.

You will need to be registered with a GP to receive an invitation to screening.

Cervical smear testing is also available at independent facilities, including Bupa Wellness centres

Deciding on cervical screening

It's your choice whether or not to have a smear test for cervical screening. To make an informed decision and give your consent, it's important that you're aware of the benefits and risks of cervical screening.

Benefits

A cervical smear test can help to pick up changes in the cells of your cervix that could lead to cervical cancer. According to Cancer Research UK, early detection and treatment can prevent around three-quarters of cervical cancers.

In 2005, around 2,800 women were diagnosed with cervical cancer in the UK. Many of the women who develop cervical cancer have never been screened or haven't been screened regularly. If you don't go for regular screening tests, early warning signs of cervical cancer could be missed.

Risks

It's important to remember that, although a cervical smear is the best way of checking the health of your cervix, it isn't a perfect test.

Sometimes, screening can show possible signs of cervical cancer when in fact there is no problem. If this happens, you will be asked to have further tests, which can cause unnecessary worry.

There is a small chance that you could be wrongly diagnosed with cervical cancer or treated for cervical cancer that would never have caused you any problems. If this happens, you may have unnecessary cancer treatment.

Up to one in 10 cervical smear tests have to be re-taken because of a problem with the test, meaning that the cells can't be seen properly. This can happen if you have an infection, if not enough cells were collected during the smear test or if the cells were hidden by blood or mucus. Therefore, it's important to try not to worry if you're called back for a repeat test.

About the procedure

A cervical screening test is usually done by a practice nurse or GP. The procedure usually takes about five minutes. Most women find it a little uncomfortable and unpleasant, but not painful.

The best time to be screened is usually 14 days after your last period. You can't be screened during your period.

You will be asked to undress from the waist down and lie on your back on a couch, with your legs drawn up and knees apart. Try to relax and breathe slowly and deeply. An instrument called a speculum will be used to gently open your vagina so your GP or nurse can see your cervix.

A sample of cells is taken from the transformation zone. This is where the lining of the inner surface of your cervix meets the lining of the outer part of your cervix.

The cell sample will usually be taken using a small brush which is then placed in liquid. This procedure is called liquid-based cytology (LBC). The sample will be sent to a laboratory for testing.

You won't usually need to have a cervical screening test if you're pregnant - it's usual to wait until three months after you have had your baby. However, this may depend on your screening history. Ask your GP for more advice.

Getting your results

Although the results of most cervical smear tests are normal, around one in 10 women have an abnormal result at some point in their life. It's important to remember that an abnormal screening result doesn't mean that you have cervical cancer.

The medical term used to describe the abnormal appearance of cervical cells on the sample is dyskaryosis. A 'borderline' or 'mild' dyskaryosis result means that very minor cell changes were found. These cells will probably go back to normal on their own and you won't need any immediate treatment. You will need to have a repeat screening test - usually in six months. If the repeat test is normal, you will be asked to have one more test in six to 12 months' time, and if this is normal you will return to routine testing. If the repeat test still shows borderline changes, you may be asked to have a colposcopy. A colposcopy is a close examination of your cervix, usually by a gynaecologist (a doctor who specialises in women's reproductive health), using a lighted magnifying instrument called a colposcope.

If your initial screening result shows 'moderate' or 'severe' dyskaryosis, this usually means that small changes have been found. A colposcopy is usually the next step.

Sometimes the result may be 'inadequate' or 'unsatisfactory' because the sample taken didn't have enough cells or you have a slight infection. If this happens, you will need to have another screening test. If you have an infection, you may need to get it treated first.

If you have any queries about cervical screening, ask your GP.