Smear tests – your common questions answered

What is a smear test?

Cervical screening (previously known as a smear test) is a test that helps to prevent cervical cancer. During the test, your doctor or nurse will take a small sample of cells from your cervix (the neck of your womb) and send it to a lab for testing.

The test checks for something called the human papilloma virus (HPV). HPV is a common infection that can sometimes cause changes to the cells in your cervix. These changes could possibly develop into cervical cancer one day. But finding and treating any abnormal cells early can reduce your chance of developing cervical cancer later in life. This is why regular screening is so important.

Lots of people have HPV without even knowing about it. Your body often gets rid of the infection by itself. So it’s really important to remember that if you have HPV, it does not mean you will definitely develop cervical cancer. But if your test comes back positive for HPV, your doctor will refer you for some more tests. They’ll check whether there are any changes to the cells in your cervix that needs treatment.

If you don’t have HPV, you won’t need any further investigations, and you’ll be invited back for another test in 3 to 5 years.

How often should you have smear tests?

In the UK, if you’re between 25 and 64 and registered with a GP as female, you’ll be invited for cervical screening every 3 or 5 years. This depends on your age and where you live, because services can vary slightly in different areas.

• In England and Northern Ireland, if you’re aged 25 to 49 you’re invited for cervical screening every three years, or every five years if you’re aged 50 to 64.
• In Scotland and Wales, you’re invited every five years if you’re aged 25 to 64.

You might be invited more often if you’ve had a smear test before, and your results came back positive for HPV or abnormal cells.

If you’re a trans man or non-binary person with a cervix, but registered as male with your GP, you might not be invited for screening automatically. But you can request to be added to the screening list through your GP or a local sexual health clinic.

Cervical screening isn’t usually offered if you’re under the age of 25. This is because it’s normal for the cells in your cervix to change at this age, and treatment could be unnecessary.

If you’re over 65 and have had normal smear tests up until now, you’re less likely develop cervical cancer. So unless you’ve had abnormal results in the past or haven’t had screening for a very long time, you won’t be invited for cervical screening. See a GP if you have bleeding after menopause. Your doctor might do a cervical screening test as part of their investigations.

Are smear tests painful?

A smear test shouldn’t feel painful, but it might feel a bit uncomfortable. The test usually takes less than five minutes, so it won’t last long. But you can ask your doctor or nurse to stop or take a break at anytime.

To help you relax, try:

• listening to music
• bringing someone with you
• asking your doctor or nurse to use a small speculum (instrument that gently opens your vagina)

It’s also a good idea to let your doctor or nurse know if you have a condition that might make a smear test more painful. For example, vaginal dryness or endometriosis. They’ll be able to make some changes to help you feel more comfortable.

Can you get a smear test during your period?

Try to book your smear test for when you don’t have your period and avoid the two days before and after bleeding too if you can. The blood could affect your test results, and you might need to have it repeated.

Do you need a smear test if you are not sexually active?

It’s still a good idea to have cervical screening (a smear test) even if you’re not sexually active. The main cause of cervical cancer is human papilloma virus (HPV). HPV is usually passed on through skin-to-skin contact during other sexual activity, not just penetrative sex. This means you can get HPV even if you’ve:

• only had oral sex or genital touching
• had sex with just one partner
• not had sex for years
• shared sex toys

If you’ve never been sexually active, your risk of HPV — and therefore cervical cancer — is much lower. But there are other things that can cause cervical cancer, so your doctor might still recommend you have a test.

Can you have sex before a smear test?

It’s best not to have sex for 24 hours before your smear test. You should also avoid using lubricants, spermicides, condoms with lubricant, or vaginal creams. These can sometimes affect your cervical cells and interfere with your sample.

What are the dos and don’ts for a smear test?

Things you should do for your smear test include:

• wear suitable clothing, as you’ll need to take off your underwear for the test
• try to relax as much as you can
• let your doctor or nurse know if you’re nervous and ask them to stop at any time

Things you shouldn’t do are:

• use spermicides, lubricants or vaginal creams in the days leading up to your appointment
• book your appointment when you have your period
• have sex 24 hours before your appointment