Smear Tests: Experts Walk Us Through The Cervical Screening Process
The number of women attending smear tests is at a 19 year low. According to charity Jo’s Trust, 1.12 million women did not take up their screening invitation in the past year.
The latest figures show cervical screening coverage in England is at just 72.7%, meaning one in four women may be at risk of a potentially life-threatening cervical cancer diagnosis.
Cervical screening is not a test for cancer. It’s a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in the cervix.
Women between the ages of 25 and 64 are invited for regular cervical screening under the NHS Cervical Screening Programme.
While many seem to believe that cervical cancer is a young woman’s disease, half of deaths occur in women over 65.
In 2012 alone, there were 919 deaths from cervical cancer – even though it’s a largely preventable illness.
To highlight the importance of cervical screenings for women of all ages, we’ve asked experts the embarrassing and personal questions surrounding smear tests, so you don’t have to.
How will I know when I need a smear test?
Jo’s Trust spokesperson, Maddy Durrant, tells HuffPost UK Lifestyle that patients will receive an invitation from their GP, who will then prompt them to make an appointment.
“You can also have a screening at a well woman clinic, family planning clinic or at the genito-urinary medicine (GUM) department of your local hospital,” adds a spokesperson for Public Health England (PHE).
Use this tool to find your nearest clinic.
What happens when you go for a smear test?
The cervical screening procedure itself lasts for a matter of minutes and is usually carried out by a GP or practice nurse.
Before the procedure starts, the doctor or nurse will explain what is going to happen and answer any questions or concerns.
Patients are then asked to undress from the waist down and lie on an examination bed, either on their back with their legs bent up or ankles together. (In some cases, examination beds might have “stirrups” on them, which feet are placed into.)
“A paper sheet will then be placed over the lower half of your body, and your GP or nurse will insert an instrument called a speculum into your vagina,” says Durrant.
“Some clinicians may use lubricant on the speculum which will make it easier to insert into the vagina. The speculum gently opens your vagina allowing them to see the cervix.”
She adds that the majority of speculums used are made from plastic, but occasionally metal ones are used. To take cells from the cervix, which will then be tested for cancer, a specially designed brush is used.
The GP or nurse will collect cells from the area of the cervix called the transformation zone. Then, the sampled cells are immersed in a vial of preservative fluid and looked at under a microscope in the laboratory.
Durrant adds that if you are worried about the procedure, you can take a friend or relative with you. You can also request for a female nurse or GP to take the sample.
Overall, the appointment should take no longer than 15 minutes with the procedure taking approximately three minutes.
Does it hurt?
“The procedure should not be painful but some women can experience a degree of discomfort and even short-term mild pain,” says Durrant. “If you feel any pain or discomfort during the procedure, please inform the GP/practice nurse.”
Additionally, a spokesperson for PHE tells HuffPost UK Lifestyle: “You might experience some discomfort or pain – try to relax by taking slow, deep breaths as it may hurt more if you are tense.”
What happens if your smear test results are abnormal?
“Once your cervical screening has been taken it will be reviewed by specialists at a cytology department, so the length of time taken to receive your screening results can vary,” says Durrant.
She adds that it’s important to ask how and when you will be notified of your results during your smear test.
But if you forget, don’t worry. According to NHS guidelines, you should receive the results of your screening within two to six weeks depending on where you live in the UK.
If there are no abnormalities seen and the test is ‘negative’, then you will be sent a letter confirming the result by your local Health Authority.
Additionally, Durrant notes that sometimes the hospital may contact you with the result. Or some GP’s request the patient to ring for their result (but it’s worth checking with them during your screening if they will do this).
“A negative result means you will be recalled for screening in three or five years dependent on where you live and your age,” reveals Durrant.
“If the specialist looking at your cervical screening test feels it would be advisable for you to be reviewed by a hospital doctor then they will inform your GP.
“More than nine out of 10 screening results are negative and around one in 20 show mild cell changes called mild dyskaryosis.
“For most women with mild cell changes, the cells will go back to normal without treatment,” says Durrant.
“One in a 100 test results show moderate cell changes (moderate dyskaryosis) and one in 200 show severe changes (severe dyskaryosis). If your results indicate that you have cell changes, you will be sent for a colposcopy to investigate it further.”
Durrant adds that it’s “extremely rare” for cancer to be diagnosed from a cervical screening test: “Less than one in a thousand women test results show invasive cancer.”
Around one in 20 women will have an abnormal result from a routine cervical screening test (smear test) that may require further testing or treatment. So, in effect, abnormal results are quite normal. Don’t worry, but do go back for further tests.