Smear Test

Cervical Smear

The cervical smear test aims at detecting cervical cancer at a very early stage. The cervix is the lower part of the uterus (the womb) and is also referred to as the neck of the womb. The neck of the womb or the cervix projects in the upper part of the vaginal canal. It can be seen using a speculum (an instrument positioned in the vagina which looks like a duck-bill). The cervix can also be felt during an internal examination.

During a smear test the surface of the cervix is scraped with a cervix brush and is either smeared onto a glass slide or placed in a liquid medium (liquid based cytology). The former is called the ‘Pap smear test’. The latter is a newer method of collecting cells from the cervix. This method preserves more cells and makes the need for a second smear test less likely than with the traditional smear test.

According to the UK Department of Health guidelines women are invited to attend for the first smear at the age of 25. Smears are carried out every three years until the age of 49. From the ages of 50 to 64, smears are carried out every five years. For women who have had treatment for abnormal cells screening may need to be performed more often. After the age of 65, women do not need to have cervical screening unless they have had recent cervical changes.

You will be invited to attend for a smear test by your local primary care trust or GP. Smear tests can also be done at family planning clinics, Well Woman clinics, sexual health or genitor-urinary clinics and at hospital gynaecological clinics. You can always ask to have it done by a female doctor or nurse. It is best to have the test in the middle of your menstrual cycle. You cannot be tested during your period.

Early detection and treatment can prevent cancer from developing in 80-90% of cases. Almost half of the women who develop cervical cancer in the UK have never had a cervical screening test. NHS cervical screening saves over 1,000 lives a year.

Cervical screening can show minor changes that may go back to normal on their own, but can cause you to worry. Cervical screening can prevent 8-9 case of every 10 cervical cancers but it does not prevent every case. Cervical screening does not pick up every abnormality of the cervix.

Around 1 in 10 tests have to be repeated because:

The cervical cells on the slide may have been hidden by blood or mucus.
There may not have been enough cervical cells on your sample to give an accurate assessment.
The smear may not have been properly prepared
Your slide may have been broken
You may have an infection that needs to be treated before a clear smear can be taken.

As screening is not 100% effective in detecting changes to the cervix you should see your doctor if you have any unusual symptoms such as abnormal bleeding, bleeding between periods, bleeding after sex or an excessive or offensive vaginal discharge.

The laboratory that examines your sample will keep it for 10 years. Your latest smear test can then be compared to the ones you have had before.

If you have been found to have an abnormal smear and you are pregnant at the time, you will be called to have a colposcopy (a more detailed examination of the cervix with a binocular on an adjustable stand). This is done as an outpatient procedure. In the majority of cases the colposcopy will show that it is safe to wait until after the baby is born before you receive treatment.

If you have had treatment to the cervix before pregnancy it is very unlikely that the treatment will affect your chances of becoming pregnant or of carrying a baby to term. If you have had a cone biopsy, this can occasionally affect future pregnancies.

If you have a concern or question about the Cervical Smear, our consultants are ready to help.

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Last page update : 12.20 - 02nd Jan 06