Your smear test results explained

What happens after my smear test?

Your cervical screening test will only take a few minutes to complete and you can go home and carry on as normal afterwards. Your cervix (the neck of your womb) is a sensitive area, so you might get a little bit of spotting. This is completely normal and should stop after a few hours, but you might decide to wear a pad just in case.

Your doctor or nurse will send your sample off to a lab for testing. The lab will check whether or not your cervical cells have an infection called human papilloma virus (HPV). HPV is a common infection that often gets better on its own, so you can have the virus without realising.

HPV is the main cause of cervical cancer. But if you test positive for HPV, it doesn’t mean you have or will definitely develop cervical cancer. However, finding it early can help prevent cervical cancer from developing in years to come.

How long does it take to get smear test results?

You’ll usually receive your cervical screening results in the post within two to six weeks. Sometimes, you might get your smear test result by text, via the NHS app, or be asked to call your doctor to find out. Your doctor or nurse can let you know when your results should be ready.

How do I read my smear results?

Your results letter will tell you whether or not you have a type of HPV called high risk HPV (hrHPV). HPV is the virus that can sometimes lead to cervical cancer. If:

• you don’t have HPV, this is known as HPV negative
• you do have HPV, it’s called HPV positive

Here we’ll break down each of the possible results in more detail.

Scenario 1: You don’t have HPV

For 9 in 10 people, your test results will come back normal. This means you don’t have HPV in your cervical cells and your risk of developing cervical cancer is extremely low. In that case, you don’t need to have any more tests, and you’ll be invited back for screening in another 3 to 5 years.

Scenario 2: You do have HPV, but your cells look healthy

If you do have HPV, it doesn’t mean you have cervical cancer. But a lab technician will take a closer look at your sample to check whether or not the infection is impacting your cervical cells. HPV can lay dormant in your body for years without causing any harm.

If your cells come back normal, you‘ll be asked to repeat the test in a year to see if you still have HPV. This is because your immune system often gets rid of HPV by itself.

If you test positive for HPV three years in a row and still have normal cells, your doctor may recommend you have a colposcopy. This is a test that helps a specialist to examine your cervix more closely.

Scenario 3: You do have HPV, and your cells show some changes

If you do have HPV, and further tests find that the infection is affecting your cervical cells, it still doesn’t mean you have cervical cancer. But your doctor will refer you for a colposcopy test to check the health of your cervix. They’ll want to see how much your cervical cells are changing.

You might be advised to monitor these changes over time. But sometimes, treatment might be recommended to remove the cells so they don’t develop into cervical cancer in the future.

Scenario 4: You need to repeat the test

Sometimes, your letter might ask you to have the test again in a few months time. It could mention that your sample was ‘inadequate’. This isn’t anything to worry about. It just means that the lab team couldn’t test your sample properly – maybe because there weren’t enough cells or there was blood in the way.

Do I need a colposcopy if I have HPV?

If your cervical screening finds that you have abnormal cells, you’ll be advised to have a procedure called a colposcopy. A colposcopy helps your doctor to get a closer look at your cervix. It’s a bit like having a smear test, except it’s done in hospital.

Your specialist will ask you to lie on your back with your legs apart and insert a speculum (instrument that gently opens your vagina) into your vagina. Then they’ll use a colposcope –a device that has a bright light and a magnifying glass – to examine your cervix closely. The colposcope stays outside your body.

During your colposcopy, your doctor might also take a small sample of cells from your cervix (a biopsy). They’ll send these to a lab to be looked at in more detail.

How do doctors treat abnormal cervical cells?

Sometimes, your doctor might recommend treatment to remove or destroy any abnormal cells so they don’t have chance to develop into cancerous cells later on. The main treatments for abnormal cervical cells include:

• Large loop excision of the transformation zone (LLETZ). Your colposcopist uses a thin wire loop to remove abnormal cells from your cervix using a small electrical current.
• Cone biopsy. A cone-shaped piece of tissue is taken from your cervix to remove abnormal cells.
• Cold coagulation. Your doctor applies heat to your cervix to destroy abnormal cells (despite the name, it uses heat, not cold).
• Cryotherapy. This is when your abnormal cells are frozen and destroyed using a very cold gas.
• Laser therapy. A focused beam of light is used to burn away abnormal cells from your cervix.
• Hysterectomy. If you’ve been through menopause or don’t want children, your doctor might suggest removing your uterus completely.