About Cervical Screening

Posted on September 21st, 2023

About cervical screening

Screening means testing people for early stages of a disease before they have any symptoms.

For screening to be useful the tests need to:

• be reliable at picking up cancers or abnormalities that could lead to cancer
• do more good than harm to people taking part
• be something that people are willing to do

·         What is cervical screening?

• Cervical screening is a way of preventing cancer. It tests for a virus called human papillomavirus (HPV). High risk HPV can cause cervical cells to become abnormal. Virtually all cases of cervical cancer are linked to high risk HPV.
• The cervix is part of the female reproductive system. It is the lowest part of the womb and is at the top of the vagina. A nurse takes a sample of cells from the cervix using a small soft brush (smear test) and sends the sample to the laboratory.

HPV primary screening

England, Wales and Scotland are using HPV primary screening. HPV primary screening tests the cervical cells for the HPV virus first. The laboratory will look to see if you have high risk HPV. If high risk HPV is found, the laboratory will test your sample for cell changes.

Up until March 2023, Northern Ireland looked for changes in cervical cells first. Since then, they’ve introduced temporary changes to how cervical screening samples are processed in the laboratory. This is to manage the current backlog caused by a shortage of qualified staff to examine the samples for cell changes under the microscope.

Samples are being tested in a two-step process:

• step one looks for HPV
• step two looks for cell changes

Step one helps the staff to prioritise the sample. So, samples positive for HPV will be looked at first for cell changes. Then, samples negative for HPV will be tested for cell changes. This will mean the higher risk samples are assessed more quickly.

There will be no change to screening intervals, which means you will still be invited for screening every 3 or 5 years, depending on your age. If a sample tests positive for HPV but has no cell changes, you will be invited for another screening test in 1 year.

Separate plans are also underway to introduce primary HPV testing permanently. These measures will be in place until this is introduced.

High risk HPV can cause cell changes in the cervix, which can develop into cancer over time. Not all cell changes will develop into cancer, but it’s important to monitor any changes and give treatment if necessary.

Who can have cervical screening?

The NHS cervical screening programme invites women from age 25 to 64 for cervical screening. You get an invite every 3 to 5 years depending on where you live and your age. You need to be registered with a GP to get your screening invitations.

For England and Northern Ireland – you get an invite every 3 years if you are aged 25 to 49. After that, you get an invite every 5 years until age 64.

How you have the cervical screening test

You can book to have your cervical screening appointment at:

• your GP practice
• some sexual health clinics
• specialist clinics for cervical screening

When to book your cervical screening appointment

Book your appointment as soon as you are invited. You do not need to wait for a letter if you missed your last cervical screening.

The best time to book an appointment is when:

• you are not having a period. Try to avoid the 2 days before or after your period. You can book anytime if you do not have periods
• you have finished treatment for unusual vaginal discharge or a pelvic infection

Having the screening test

A female nurse usually does the screening test. Talk to them if you feel at all nervous about having the test. They can help reassure you. The test itself only takes a minute or two.

Your nurse will ask you to remove your clothes from your waist down, including your underwear. You can usually keep on a loose fitting skirt. You lie on your back on a couch. Your nurse can give you a paper towel to cover your hip area.

You generally lie with your knees drawn up and spread apart. If this is difficult for you, you can lie on your side with your knees drawn up.

Your nurse gently slides a plastic instrument called a speculum into your vagina so that they can see the cervix clearly. Having the speculum put in may be a little uncomfortable.  It can be more uncomfortable if you are very tense. So try to relax. Taking some deep breaths can help. Your nurse will help you to relax.

Your nurse uses a soft brush to take some samples of cells from the surface of your cervix. They put the sample into a pot of liquid to send to the laboratory. They take out the speculum and the test is over. You can then get dressed and go home.