Cervical screening: who is eligible for a smear test, what it tests for, and how often you need one

Cervical screening checks a sample of cells from the cervix for types of HPV which can cause abnormal changes
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Cervical cancer is the most common type of cancer among women aged 35 and under and affects around 3,200 people in the UK every year.

The cancer develops in a woman’s cervix and is most common among sexually active women between the age of 30 and 45.

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Attending a cervical screening, or a smear test, when invited by the NHS is the best way to protect against this type of cancer as it can boost early detection, meaning treatment can be sought early.

While screenings are offered to all women between the age of 25 and 64, more than 20 per cent of women who are eligible do not attend their appointment when called.

The screening programme helps to prevent more than seven in 10 diagnoses, according to Jo’s Cervical Cancer Trust.

It can also prevent around 45 per cent of cervical cancer cases in women in their 30s, rising to 75 per cent of cases among women in their 50s and 60s, who attend regular screenings.

Why is cervical screening important?

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Cervical screening checks a sample of cells from the cervix for certain types of human papillomavirus (HPV) which can cause abnormal changes - it is not a test for cancer.

In most cases the test results show that everything is normal, although around 1 in 20 cases show some abnormal changes in the cells of the cervix.

If these types of ‘high risk’ HPV are found during a screening, the sample of cells is then checked for any abnormalities. If these abnormal cells are left unchecked, they could develop into cervical cancer.

It is estimated that if everyone attended screening regularly, 83 per cent of cervical cancer cases could be prevented.

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Dr Neil Smith, GP and cancer director for Lancashire and South Cumbria said: “It is not a test for cancer, it’s a test to help prevent cancer by detecting early abnormalities in the cervix, so they can be treated. If these abnormalities are left untreated, they can lead to cancer of the cervix (the neck of the womb).

“I would recommend that every woman invited should have the test. We know that on average cervical screening helps save the lives of approximately 4,500 women in England every year.

“The word cancer can create fear and negative emotions. By talking about it we identify these feelings, and it helps to put things into perspective.

“Making cancer part of everyday conversations encourages people to attend appointments for cancer screening and tests or hospital reviews for suspected cancer.”

Who is eligible for cervical screening?

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Cervical screening is free and all women and people with a cervix aged 25 to 64 who are registered with a GP are automatically invited for the test. This includes those who have had the HPV vaccination.

Regular screening means any abnormal changes in the cells of the cervix can be identified early and, if necessary, treated to protect against cancer developing.

How often do I need a screening?

Women aged 25 to 49 are advised to attend a screening appointment every three years, women aged 50 to 64 should attend every five years, and those over 65 should only attend if one of their last three tests was abnormal.

As well as attending screening when you are invited, other signs of cervical cancer to look out for include any abnormal bleeding or unpleasant discharge or pain after sex. If you notice anything unusual, you should make an appointment to see your doctor and get it checked.

When should I book my appointment?

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The NHS recommends booking 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.

It is best to make an appointment when you don’t have your period, if possible.

It is recommended that you do not have a cervical screening whilst pregnant, but if you have had abnormal results in the past, or your obstetrician has concerns about the health of your cervix, an examination may be considered.

You will be sent an letter in the post when it is time to book your appointment. This will include information on where you can attend your appointment and how to book it.

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Most screenings are carried out in a GP surgery by a female nurse or doctor, but in some parts of England you may be able to go to a sexual health clinic instead.

Your letter will tell you where you can go for cervical screening and how to book.

What happens at the screening?

You will be asked to undress from the waist down and lie on a couch, although some women prefer to wear a dress or a skirt that they can lift up to their waist.

A doctor or nurse will gently insert an instrument called a speculum into your vagina, which holds the walls open so the cervix can be seen.

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A sample of cells will then be collected from the surface of your cervix using a small, soft brush.

Some women find the test slightly uncomfortable, although this is often due to feeling tense about the procedure.

Taking slow, deep breaths will help you to relax, but if you find the test painful, inform the doctor or nurse as they may be able to reduce your discomfort.

The screening normally takes around five minutes to carry out and you should receive the results of the test within two weeks. The results will be sent to you in the post, with a copy also sent to your GP.

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