What To Know Before Your First Smear Test

“Cervical screening – otherwise known as a smear test – is a short exam which checks the health of your cervix. The smear test is a screening test for cervical ‘pre’ cancer. Smear tests look out for the presence of certain types of human papillomavirus (HPV) by collecting a small sample of cells from your cervix. The types of HPV that are looked for are those which can potentially cause abnormal changes to the cells in the cervix. If HPV is found in the smear test, making the result ‘HPV positive’, the cells are then tested to see if there have been any abnormal changes, as this is what can put you at a heightened risk of developing cervical cancer.” – Professor Jay Chatterjee, consultant gynae-oncologist at The Lister Hospital, part of HCA Healthcare UK

“HPV is the name for a very common group of viruses. Nearly all cervical cancers are caused by infection from certain types of HPV, so your smear test helps identify if this bug is present or not. You can get HPV from a sexual partner from any kind of contact with the genital area, not just from penetrative sex, and most people will get some type of HPV during their lives, so don’t worry if you are found to have this – not every type of HPV leads to cervical cancer.” – Samantha Miller, GP at Yoppie

“Having a smear test could save your life. Stats from Public Health England show regular screening prevents up to 83% of cervical cancers. But remember, cervical smears are not looking for cervical cancer. They are looking for precancerous changes which, if left untreated, could go on to become cancer. Unfortunately, attendance for cervical screening is the lowest it’s ever been, with one in four women not attending a test they’ve been invited to. And yet, women who do attend for a smear test, generally have a positive experience, with 87% saying they are glad they went, and 84% saying they were put at ease by the nurse or doctor doing the smear.” – Dr Deborah Lee, GP at Dr Fox Online Pharmacy 

“Women in the UK are offered a cervical smear every three to five years between the ages of 25 and 64. You need to be registered with a GP surgery and will get a letter automatically inviting you to make an appointment when it’s time. From age 25-49, smears are taken every three years, and from 50- 64, every five years.” – Deborah

“The nurse or doctor will start by asking you a few questions – the date of your last period, whether you’re using hormonal contraception, and if there is any chance you could be pregnant. You’ll also be asked if you have had any symptoms such as bleeding in between your periods or after sex. You’ll also be asked if you want a chaperone present when the test is done. A chaperone is an independent person who is there to give you confidence and act as a pair of eyes and ears if anything untoward was to happen – which is highly unusual. If you want a chaperone, you can ask for a male or a female chaperone but if one is not available in the clinic at that time, you will be asked to come back for another appointment. A medical student or a junior doctor may sometimes be in the smear clinic getting experience. You may be asked if you mind having one of them present when you have your smear, and you are quite at liberty to say no.” – Deborah

“You’ll be asked to lie on your back, with your knees bent upwards, slightly apart, or sometimes, they will ask you to put your legs up in stirrups. The nurse will then insert an instrument called a speculum into the vagina. A speculum looks a bit like a duck's beak. It may be metal, or more often these days they are single-use, made of latex-free plastic. The speculum is inserted closed and then opened gently once it is high enough into the vagina, so the nurse can see the whole cervix, which looks like a Polo mint. It can be tricky to get a good view of the cervix, which means manipulating the speculum a little, and sometimes this causes some mild discomfort, but it is usually short-lived. Once the cervix is in full view, the nurse uses a soft brush to sweep 360° around the cervix several times, to collect cells from the surface of the cervix. The whole test takes ten to 15 minutes.” – Deborah

“It may feel a little uncomfortable, but it should not be painful. However, discomfort is one of the main reasons why women are put off having their smear, so it may be helpful to know you can take paracetamol 30 minutes before your appointment, which will minimise some of the discomfort. You can also ask the nurse to use a plastic speculum or a smaller speculum. These aren’t always available, but don’t be afraid to ask.” – Mr Narendra Patel, consultant gynaecologist at London Gynaceology

“It can take up to 14 days to get the results of your test back but try not to worry if it comes sooner or later than expected. Many people receive a negative result while others will be told further investigation is required. If the result comes back saying HPV has been found but no abnormal cells have been detected, you might need to attend a repeat screening after a year. Alternatively, if the results come back stating HPV and abnormal cells have been found, you will be asked to have a colposcopy to look at the cervix. This is a very simple procedure using a magnified telescope. Sometimes people receive unclear results – this is known as an ‘inadequate result’. This doesn’t mean anything is wrong. In these cases, you might be asked to have another test in three months.” – Jay

“You can have a smear test any day of your cycle when you’re not bleeding. If you are having natural cycles and not using hormonal contraception, the test may be more efficient if done mid-cycle – around day 14 – but with modern techniques, this is rarely needed.” – Deborah

“Avoid using lubricants, spermicides or vaginal creams for 48 hours before your smear, and try not to have sex 24 hours before.” – Deborah

“Yes, you still need to have a smear test even if you have been vaccinated against HPV. This is because the vaccination does not protect you against all strains of HPV – there are many different subtypes. When the HPV vaccination was first introduced between 2008-2012, data shows teenage girls immunised at this time have had an 87% reduction in cervical cancer. Although this is an excellent result, it shows that the vaccination did not give 100% protection, and therefore smears are still required.” – Deborah