Cervical cancer screening or; the ‘smear’ is something that we, as women, know is on the to do list but it isn’t usually at the top. This is sometimes due to not knowing the process or the reasoning behind it; and often we “woman up” and get on with it. June 15-21st is Cervical Cancer Screening Awareness Week and I am here to tell you everything you need to know about the dreaded smear so you can feel empowered to take part!

Why do I need to have it done?

The aim of cancer screening is to look for the possible presence of cancer before any symptoms occur so treatment can be started as soon as possible. The earlier the cancer is detected the better the treatment options and survival rate. Since cervical cancer screening has been introduced, the number of women dying from cervical cancer has halved. 

Will it tell me if I have cancer?

In a word….no. Cervical screening looks for abnormalities that may indicate the presence of cancer. If screening picks up any abnormalities, then you will need further testing before a cancer diagnosis can be made. The screening process involves three steps:

1) Detecting whether Primary Human Papillomavirus (HPV) is present

2) Looking for abnormal cells in the sample. 

3) If there are abnormal cells, you will be invited for camera test which will look at your cervix followed by a biopsy.

The first two steps are from the sample that is taken at your GP surgery. You will be told if there are abnormalities requiring you to go for the camera test, so you can be reassured that if it comes back as normal that means there are no concerns. There are other possible outcomes of more regular testing but this will be discussed with you. 

What is HPV?

Primary Human Papillomavirus is a virus that has been found to be the main cause of cervical cancer. Persistent infection for longer than 2 years can lead to cervical cancer developing. The risk of getting HPV increases with those who have had multiple sexual partners, unprotected intercourse and also, if your sexual partner has HPV.

When do I need to have it done?

In England:  You will receive an invitation through the post when you are 24.5 years old then; 

  • Between 25-49 years old, you will be screened every 3 years
  • Between 50-64 years old it will be every 5 years. 

Some women over 65 years old are screened the main reasons for this would be: recent abnormal screening results, you haven’t been screened since the age of 50.

If you are pregnant then routine screening is delayed until 3 months after you deliver. If there is a smear abnormality and then you find out you are pregnant, you should still be seen for the next steps. 

What happens when I go for a smear?

You will be invited by your GP practice when you are due for a smear, usually in a letter through the post. The practice nurse usually does the smear and they will talk you through the process. Once they have explained the process and you are happy for them to go ahead, the next step is to pop you on the examination couch and insert a speculum into the vagina which helps them locate your cervix. A sample is collected using a soft plastic brush that is swept over the top of the cervix and then this is placed in a pot with a solution which is then sent to the lab. There may be a small amount of bleeding afterwards, but this is nothing to be concerned about.

Does it hurt?

I’m not going to tell you that it is the most comfortable experience, but it shouldn’t hurt and you should not be in pain. With any intimate examination, you can ask the clinician to stop at any time. As much as I encourage you to get the smear done, if you are uncomfortable, apprehensive, or have concerns about any part of the test, you can say no. If you do have concerns about an intimate examination, you can and should, discuss them with the clinician before starting. They then can talk through it with you and make adjustments, if possible.  

Are there any symptoms of cervical cancer or HPV that I should know about?

There are no symptoms of this infection and often there are no symptoms with cervical cancer which is why the screening is so important. However, there are some symptoms to look out for:

  • Bleeding between periods
  • Bleeding after intercourse
  • Blood stained discharge
  • Pain in you lower stomach, particularly during intercourse. 

A smear is just for screening not diagnosing cancer, so if you have these symptoms then other tests may need to be done so please contact your GP. 

Written by Dr Rebecca Suttie (MBChB) CGUK member and GP