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Cervical Smear Test
What is cervical screening?
Cervical screening is not a test for cancer. It is a method of preventing
cancer by looking for early changes in the cells on the cervix which might,
if ignored, develop into cancer over some years. It is a screening test,
which means that its purpose is to detect a problem of which there are
no easily noticed warning signs
For many women the test results show that everything is fine. But for one in 10 women, the test shows changes in the cells that can be caused by many things. Most of these changes will not lead to cervical cancer. Cervical screening saves over 1,000 lives in the UK each year, but unfortunately about 1,500 women die from cervical cancer in the UK every year
Should all women have the test?
The current policy of Leeds Student Medical Practice, in accordance with
national guidelines, is to offer cervical screening to women every three
years from the age of 25 to 49, and every five years from 50 to 64. As
the development of cancer of the cervix is generally very slow, testing
at these intervals is enough to prevent the vast majority of cases of
serious disease. We do know that cervical cancer is more common if you: first had sex at an early age; smoke; do not use
condoms; have had several sexual partners or have had a sexual partner
who has had several other partners; or take immunosuppressant drugs (for
example, after an organ transplant). If you have passed the menopause,
you still need to be tested to check that your cervix is healthy. Ask
your doctor for specific advice if you: have had a hysterectomy; are over
65; have never had sex; or you are not sure whether you still need to
be tested
If you are aged between 25 and 64 you will
automatically receive an invitation letter
every three to five years. www.cancerscreening.nhs.uk
About the test
The doctor or nurse will ask you to undress from the waist down (but if you wear a skirt you will not have to remove it), then lie down on a couch. They will then
gently put a small instrument, called a speculum, into your vagina to
hold it open. Then, they will wipe a smooth wooden or plastic spatula
over the cervix to pick up a few of the cells. They will transfer these
cells to a slide and send it away to be examined under a microscope. The
test takes just a few minutes. You might experience some discomfort or pain - try to relax by taking
slow, deep breaths as it may hurt more if you are tense. If it is painful,
tell the doctor or nurse straight away as they may be able to reduce your
discomfort
Is there anything I should do before the test?
You cannot be tested during your period so make sure you get an appointment
before or after your period is due.
If you use a spermicide, a barrier method of contraception or a lubricant
jelly, you should not use these for 24 hours before the test as the chemicals
they contain may affect the test
When do I get my results?
When you have the test, the doctor or nurse will tell you how, where and
approximately when you will get your results. Make sure you have received
this information before you leave the surgery
How reliable is cervical screening?
Early detection and treatment can prevent 80 to 90% of cancers developing
but, like other screening tests, it is not perfect. It may not always
detect early cell changes that may lead to cancer. Abnormal cells on your
slide may not be recognised because: sometimes they do not look much different
from normal cells; there may be very few abnormal cells on the slide;
or the person reading your slide may miss the abnormality (this happens
occasionally, no matter how experienced the reader is). About one in 10
tests have to be taken again because: you may have an infection which
needs treating before a clear slide can be made; the cervical cells on
your slide may have been hidden by blood or mucus; there may not have
been enough cervical cells on your slide to give an accurate assessment;
your sample may not have been properly prepared; or your slide may have
been broken. If you have any unusual symptoms, such as bleeding after
sex or between periods, you should see your doctor
What does it mean if I am called back?
Age is an important factor, and younger women are less likely to have a serious
cervical problem, but more likely to have an abnormal result that needs
follow-up. It might simply mean
that your sample did not show up clearly and that we need to take another
test. This is called an 'unsatisfactory result'. On the other hand, your
result could identify some small changes in the cells of the cervix. If
abnormal changes (known as dyskaryosis) are detected, you will have what
is called an 'abnormal result'. This is not cancer. However, sometimes
cancer will be found when an abnormal test is investigated further. Cervical cancer is very rare in women under 25
Can anything be done about abnormal changes?
Yes. Your doctor or nurse will explain what needs to be done. Mild abnormalities usually result in advice to have
the next test carried out at an earlier interval. More significant changes
require Colposcopy - a hospital procedure involving viewing the cervix
under magnification and treating suspect areas. Out of 4,000 smear tests,
approximately 250 will be mildly abnormal, and of those 50 will require
treatment, of those 50, 1 could have developed into Cancer
Can cervical screening prevent cancer?
Regular cervical screening every three to five years is the best way to
detect changes to the cervix early. Early detection and treatment can
prevent cancer developing in around 80 to 90% of cases
What happens to my sample once it has been looked at?
The laboratory that looks at your sample will keep it for at least 10
years. They can then compare your latest result with the ones you have
had before. This is to make sure that you get any treatment you may need.
They may review all screening records, including your sample, as part
of our aim to offer a quality service and to help increase the expertise
of specialist staff. When a review shows that you should have been cared
for differently, we will contact you. We will offer you information about
the review of your case if you want to know it. For more details about
the records we keep, you can contact NHS Choices on 0845 4647
Source: Health Promotion England in conjunction with the NHS Cervical Screening Programme and Cancer Research Campaign
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