What Is A Smear Test? Experts Walk Us Through The Cervical Screening Process

Everything you need to know about the test itself and what the results might mean.

If you’ve never been for a smear test before, the uncertainty surrounding the process can cause a huge amount of (often unnecessary) worry.

The aim of smear tests, also known as cervical screening, is to spot any abnormalities within the cervix that could, if undetected and untreated, develop into cervical cancer.

Women between the ages of 25 and 64 are invited for regular cervical screening under the NHS Cervical Screening Programme in England.

To highlight the importance of the tests for women of all ages, we asked experts the embarrassing and personal questions so you don’t have to.

How will I know when I need a smear test?

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).

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,” a spokesperson for cervical cancer charity Jo’s Trust told HuffPost UK.

“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.

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,” according to a Jo’s Trust spokesperson. “If you feel any pain or discomfort during the procedure, please inform the GP/practice nurse.”

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 a spokesperson for Jo’s Trust.

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.

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,” says Jo’s Trust’s spokesperson.

“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.

“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.”

It’s “extremely rare” for cancer to be diagnosed from a cervical screening test, according to Jo’s Trust. “Less than one in a thousand women test results show invasive cancer,” its spokesperson says.

Around one in 20 women will have an abnormal result from a routine cervical screening 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.