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Cervical screening

Cervical screening is a way of preventing cancer of your cervix (the neck of your womb). The screening test checks for changes in the cells of your cervix that may, if untreated, develop into cervical cancer. Catching and treating any changes early can help to stop this happening.

Cervical screening is sometimes called a smear test. You may also have heard the term Pap smear, which is how people often refer to it in the US. Cervical screening isn't a test for cancer. It’s designed to pick up abnormal changes to cells in your cervix that could become cancer in the future if they aren’t treated.

During a cervical screening test, your nurse or GP takes a small sample of cells from an area on the surface of your cervix. These cells are then sent to a laboratory where they are examined using a microscope to check for any changes.  

he NHS runs a cervical screening programme in the UK. In England, Wales and Northern Ireland, women between 25 and 64 years old are invited for screening. In Scotland, women aged 20 to 60 are included in the programme. On 1 April 2016, the age range for cervical screening in Scotland is changing to 25 to 64 to match the rest of the UK. 

At the moment, doctors think that the harms of screening women under the age of 25 outweigh the benefits. Cervical screening is less effective in women aged 20 to 24 than in older women. It’s common to have changes in the cells of your cervix when you’re younger and most of these go away by themselves. Treating these changes unnecessarily could lead to issues later on. 

If you’re registered with a GP, you’ll usually be invited to have cervical screening once every three years. From the age of 50, this usually becomes once every five years. You can also have cervical screening elsewhere, such as at a family planning or sexual health clinic, or at a private facility. 

If you’ve never had sex, you’re at an extremely low risk of developing cervical cancer so you may decide not to have the test. If you’re not currently sexually active but have been in the past, you should still go for cervical screening. If you’ve had a hysterectomy, you probably won’t need to have cervical screening unless your cervix wasn’t removed. You may be invited to go for a different type of test, called a vault smear, depending on why you had a hysterectomy.

It’s important to remember that cervical screening is for women who don’t have any symptoms. If you have symptoms you’re worried about, like bleeding after sex or other abnormal vaginal bleeding, pain or a discharge, see your GP. Don’t wait for your routine cervical screening appointment.

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  • Making a decision Deciding on cervical screening

    It's your choice whether or not to have a cervical screening test if you’re offered one. It’s important to understand all the benefits and risks.


    Cervical cancer affects about 3,000 women in the UK every year. It’s the most common cancer in women under the age of 35. Cervical screening can help to pick up changes in the cells of your cervix that could lead to cervical cancer in the future. Since the national cervical screening programme was introduced, the number of women getting cervical cancer has fallen greatly. It’s believed that cervical screening saves about 5,000 lives every year in the UK. 

    Cervical screening is the best way to detect the changes that lead to cervical cancer. Many of the women who get cervical cancer have never been screened. 


    It's important to remember that although cervical screening is the best way of checking the health of your cervix, it isn't a perfect test. Like all screening tests, it can’t be 100 per cent effective. 

    It’s possible some abnormal cells may be missed in your test. This is because abnormal cells sometimes look very similar to healthy cells, or there may not be many of them. This means you could be wrongly told your cells are normal, when in fact you may have some abnormal cells that could develop into cancer. This is called a false negative test. 

    Your screening test may show up mild cell changes in your cervix, which would never have gone on to become cancer or caused you any problems. If this happens, you may receive treatment that you don’t really need. Very occasionally, screening can show you have abnormal cells when in fact there’s no problem. This is called a false positive result. If your test shows abnormal cells, you’ll be offered further tests, or treatment which may cause you unnecessary worry if it turns out you didn’t really need them.

  • Preparation Preparing for cervical screening

    Make your appointment for cervical screening for a time when you’re not having a period. The best time is halfway between one period and the next. This gives the best chance of a good sample. If you’re bleeding at the time of your cervical screening test, the sample may not be clear. This means you may need to come back and be tested again. 

    Don't have sex using a spermicide, lubricating jelly or a barrier method of contraception, such as a condom, for 24 hours before you have the test. The chemicals in these products can affect the test.

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  • The procedure What happens during cervical screening?

    A cervical screening test usually takes just a few minutes. Your test will be carried out by your nurse or GP. If you would prefer to have your test carried out by a female doctor or nurse, mention this when you make your appointment.

    Your nurse or GP will ask you to undress from the waist down. They will then ask you to lie on your back on a couch, with your legs drawn up, ankles together and knees apart. If you can’t get into this position easily, you can lie on your side for the test.

    You may find the test uncomfortable but it doesn’t usually hurt. Try to relax and breathe normally. Let your nurse or GP know at the time if it feels painful.

    Your nurse or GP will use an instrument called a speculum to gently open your vagina, so that they can see your cervix. They will take a cell sample from your cervix using a small brush. The sample is then placed into a container of liquid and sent to a laboratory for testing.

    If you're pregnant and have had normal screening tests previously, your GP will probably postpone any routine screening until three months after your baby is born. If you’ve had an abnormal test and then become pregnant, you may be asked to have a test at your first antenatal appointment.

  • Aftercare What to expect afterwards

    You can carry on as normal after your smear test and go about your normal daily routine. You don’t need to take any specific precautions. You may have some light bleeding after your cervical screening test. If you have heavy bleeding or pain afterwards, see your GP.

  • Getting your results Getting your results

    You should be told how and when you can expect to receive your results. But ask the person taking your test if you’re not sure. The results should be sent to the surgery or clinic where you had the test done. A copy may also be sent to your home address. Some GPs ask you to phone them for the result. Your result should be ready after about two weeks, but may take as long as six weeks. If you don’t hear anything within six weeks, contact your GP or clinic.

    Most cervical screening tests – more than nine out of 10 – are normal or negative. If your test is normal, you’ll be invited back for routine screening after three or five years, depending on your age.

    Sometimes the result may be 'inadequate' or 'unsatisfactory' because there weren’t enough cells in the sample, or the cells could not be seen clearly. This may be because of an infection or because you were having your period. This happens in about two to three in every 100 tests. If your test result is inadequate, you’ll be asked to have another test after three months. The delay of three months is to allow your cervix to renew itself; otherwise the result may not be accurate.

    Getting an abnormal result

    About one in 20 women who have a cervical screening test will get an abnormal result. If you get an abnormal result, it doesn’t mean you have cancer. It means that you have some changes to the cells from your cervix (called dyskaryosis). These changes might go away on their own, but for some women the changes might develop into cancer if not treated. If your cervical screening test shows abnormal cells, you’ll be offered further tests to see if you need treatment.

    Borderline or mild changes

    Your test result may say that you have cells with ‘borderline’ or ‘mild’ changes. These don’t usually develop into cancer and may well return to normal by themselves. If you have borderline or mild changes and you live in an area where human papilloma virus (HPV) testing is done, your sample will be tested for high-risk HPV. This is because certain types of HPV can increase your risk of cervical cancer. If high-risk HPV is found in your sample, you’ll be offered a further test called a colposcopy. This is similar to cervical screening but allows your cervix to be examined much more closely. If there is no high-risk HPV in your sample, you won’t need any further tests and can go back to having routine cervical screening.

    If you don’t live in an area where HPV testing is done, you’ll be asked to come back for another cervical screening test after six months. If the cells haven’t gone back to normal, you’ll be referred for a colposcopy. If the cells have returned to normal, you’ll need to have two more screening tests at six-month intervals to check that they stay healthy.

    Moderate or severe changes

    Your test result may say that you have cells with ‘moderate’ or ‘severe’ changes. Even if you have these changes, it is still unlikely that you have cancer. But cells with these changes are less likely to return to normal on their own and usually need treatment. You’ll be offered a colposcopy to examine your cervix and to see if treatment is needed. See our FAQ ‘How are abnormal cervical cells treated?’ for more details about treatment.

    If you have any questions about cervical screening, speak to your GP or nurse.

  • FAQs FAQs

    Can cervical screening pick up an infection if I have one?


    Cervical screening aims to detect changes to the cells in your cervix, rather than check for infection. However, if you have an infection, this may sometimes be picked up during the test.


    The cervical screening test is designed to check for abnormal cells in your cervix. The test won't look specifically for any infection unless your doctor or nurse asks for a swab to be tested.

    The sample taken during your cervical screening test will be sent to a laboratory. If the laboratory finds signs of an infection they will report it to the person who took the test. Not all vaginal infections show up in a cervical screening test. Infections that may be reported by the laboratory include Candida (thrush), herpes simplex 2 (a viral infection) and Trichomonas (a tiny parasite). If your cervical screening test suggests you may have an infection, your GP may offer you treatment or refer you to a sexual health clinic.

    You will be offered another cervical screening test once your infection has gone.

    Symptoms of a vaginal infection may include:

    • unusual vaginal discharge  
    • irritation, itching and soreness of the vulva (the skin around the outside of your vagina)
    • pain in your lower abdomen (tummy) 
    • pain when passing urine
    • pain and/or bleeding during or after sex
    • bleeding between periods

    See your GP if you have any of these symptoms.

    Do I need a cervical screening test if I don't currently have a sexual partner?


    Yes. It’s important to have your routine cervical screening test even if you don't have a sexual partner at the moment.


    Cervical screening is a test to check the health of the neck of your womb (cervix). The test checks for changes in the cells of your cervix that may, if untreated, develop into cervical cancer.

    Changes in the cells of your cervix usually develop as a result of infection from a virus called human papilloma virus (HPV). There are different types of HPV and some of them are linked to the development of cell changes and to cervical cancer.

    HPV infections are very common and can be passed on through sexual contact. Most women get HPV at some point in their lives. Most of the time your body fights off the infection and you won't know that you have had the virus. Cervical screening checks for the cell changes that are caused by HPV infection.

    If you’ve had sex in the past, even if you're not sexually active now, you should still have regular cervical screening. This is because you may have been infected with HPV from a previous partner, even if it was months or years ago.

    If you’ve never been sexually active, you’re very unlikely to develop cervical cancer. But there may still be some small risk, so you may decide you do want to have regular cervical screening.

    If you're lesbian or bisexual, it’s still important that you have regular cervical screening. This is because HPV can be passed on through sexual contact between women.

    How are abnormal cervical cells treated?


    There are a number of different treatments, which either destroy the abnormal cells or remove the area of your cervix where the cells are located.


    About one in 20 women who have a cervical screening test will get an abnormal result. If you get an abnormal result this doesn’t mean you have cancer.

    Cells showing borderline or mild changes will often return to normal without any treatment. If you have these cells, your GP may recommend that you have a further screening test done after six months. This is to check whether or not the changes are still present. If the changes are still there after six months, you will be offered a colposcopy – this test is similar to cervical screening but enables your cervix to be examined more closely. If you live in an area that does HPV testing on cervical screening samples then procedures may be different. Your GP will let you know exactly what will happen. See ‘Getting your results’ for more details.

    If your cervical screening test shows cells with moderate or severe changes, you’ll be asked to have a colposcopy. Most colposcopy clinics are in hospital outpatient departments. If the doctor or nurse doing your colposcopy finds an area of your cervix that looks abnormal they will take a biopsy. This is a small sample of the abnormal tissue that is then sent to a laboratory for testing. Depending on the result of your biopsy, you may need to have treatment. The aim of treatment is to remove or destroy your abnormal cells, while causing as little damage as possible to healthy tissue.

    There are two main ways of removing abnormal cells.

    • Large loop excision of the transformation zone (LLETZ). A wire loop with an electric current is used to remove abnormal areas of tissue. You will usually have this procedure done under local anaesthesia which means you will be awake. But if you’re very anxious, you may be able to have general anaesthesia which means you will be asleep during the procedure.
    • A cone biopsy. A small, cone-shaped section of abnormal tissue is taken from your cervix to remove the cells that could become cancerous. You will probably have a cone biopsy done under general anaesthesia.

    Other treatments that are sometimes used to destroy abnormal cells include laser therapy, cryotherapy (freezing) and cold coagulation.

    Ask your GP or nurse for more information on these treatments.

  • Resources Resources

    Further information


    • Cervical cancer. BMJ Best practice., published 18 July 2013
    • Cervical screening (cervical smear test). PatientPlus., published 20 October 2014
    • Colposcopy. PatientPlus., published 1 March 2013
    • Cervical carcinoma. PatientPlus., published 16 May 2012
    • Cervical screening. NICE Clinical Knowledge Summaries., published June 2013
    • About cervical screening. NHS cervical screening programme., accessed 12 January 2015
    • NHS cervical screening – the facts. NHS Cancer Screening Programmes. Department of Health, 2012.
    • Cervical screening – what your abnormal result means. Department of Health, 2012.
    • Cervical screening – the colposcopy examination. Department of Health, 2008.
    • International Agency for Research on Cancer. World Health Organization. IARC handbook of cancer prevention, volume 10, cervix cancer screening. Lyon: IARC Press; 2005
    • Cervical cancer screening. Cancer Research UK., published 29 December 2014
    • Cervical cancer incidence statistics. Cancer Research UK., published 11 June 2014
    • Cervical cancer. Cancer Research UK., published 2 June 2014
    • Cervical cancer screening. Information Services Division Scotland., accessed 12 January 2015
    • Cervical screening. NHS Health Scotland., published October 2014
    • Cervical screening Wales., accessed 12 January 2015
    • Cervical cancer. NIdirect government services., accessed 12 January 2015
    • Sasieni P, Castanon A, Cuzick J. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 2009; 339. doi:10.1136/bmj.b2968
    • Cervical screening. Macmillan., published 1 October 2012
    • NHS cervical screening: helping you decide. Informed Choice about Cancer Screening, 2013.
    • Cervical screening (smear test). Jo’s cervical cancer trust., published 31 May 2013
    • About cervical cancer. Jo’s cervical cancer trust., published 21 November 2013
    • Cervical smears and pregnancy. Royal College of Obstetricians and Gynaecologists, 2013.
    • Cervical Screening Programme, England 2012-13. Health and Social Care Information Centre, 2013.
    • Sexually transmitted infections (STIs) help. Family Planning Association., accessed 12 January 2015
    • Anaesthesia explained – third edition. The Royal College of Anaesthetists, 2008.
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