Cervical Cancer Prevention week (22-28 January)
Join us to raise awareness of smear tests for the prevention of cervical cancer
What is a smear test & What are we looking for?
A cervical screening test (also known as a smear test / PAP smear) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina. It is a simple test to carry out, where the doctor or nurse will gently put an instrument, called a speculum, into your vagina. This holds the walls of the vagina open so the cervix can be seen. A small soft brush will be used to gently collect some cells from the surface of your cervix.
Cervical screening isn’t a test for cancer but a test to check the health of the cells of the cervix (neck of the womb). If any abnormal cells are detected the test is now automatically analysed for the virus HPV (human papilloma virus). If a sample taken during the cervical screening test shows low-grade or borderline cell abnormalities, the sample should automatically be tested for HPV. If HPV is found in your sample, you should be referred for further investigations (colposcopy) and, if necessary, treatment.
There are more than 100 different types of HPV. Some types are high risk and some types are low risk.
If no HPV is found, you’ll carry on being routinely screened as normal or at a shorter time interval if there are any abnormalities. Around 1 in 20 smear tests taken can show abnormalities, many of these may go back to normal on their own. Most of these changes won’t lead to cervical cancer. However, in some cases, the abnormal cells need to be removed so they can’t become cancerous.
Who should have one?
It’s possible for women of all ages to develop cervical cancer, although the condition mainly affects sexually active women aged 30 to 45. The condition is very rare in women under 25. The NHS screening campaign applies to women:
• aged 25 to 49 – every three years
• aged 50 to 64 – every five years
• over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests
Age brackets can differ in different boroughs and parts of the country. You can find out from your local health authority or your medical practice what this is.
In the private sector, a smear test can be organised for any sexually active women from any age if clinically indicated or required. Equally if you are under the age of 25 and your doctor has refused a smear test, this needs to be reviewed taking into account your sexual history, symptoms and current concerns.
The national health does not routinely fund smear tests outside of these age brackets or at more frequent intervals. It is important you still discuss your concerns with your practitioner even if this is the case.
When should one be performed?
If possible, try to book an appointment during the middle of your menstrual cycle (usually 14 days from the start of your last period), as this can ensure a better sample of cells is taken.
However this will not always apply if you are on a contraceptive device or pill that can make your cycle irregular.
You should not use any lubricants, creams or barrier contraception 24 hours before a smear test.
If you are struggling to book your appointment around a convenient time in your cycle do speak to your doctor to see if the test can be coordinated for you. You may require medications to stop persistent bleeding related to your contraceptive method so that your test can be performed (this is not uncommon with contraceptive coils or implants).
You should not routinely have a smear test performed during pregnancy unless indicated by a gynaecologist for ongoing problems.
Post pregnancy, you should not have a smear test during the first 6 weeks after delivery, to allow the cells around the neck of the womb to settle from the hormonal changes during pregnancy and any trauma post delivery. If you are under 25 years old and have recently had a child, you should speak to your GP or gynaecologist as to whether one is appropriate for you.
What happens after a smear test?
It is not uncommon to have a little spotting or bleeding in the first couple of hours after your smear test. Any persistent irritation or discharge however (after 24 hours) should be discussed with your practitioner.
Results will be sent to you by the local screening centre, or if performed privately, by the method discussed with your Doctor or nurse.
The results will be explained to you and any follow up, repeat tests or further investigations will be discussed accordingly.
Don’t be embarrassed to get your smear test done – 2 minutes of discomfort for peace of mind and prevention of cancer.