Your Doctor

Cervical Smear - The Facts

1) Cervical cancer develops in a woman's cervix (the entrance to the womb from the vagina). It mainly affects sexually active women aged between 30 and 45.

2) What causes cervical cancer?

Almost all cases of cervical cancer are caused by HPV (Human Papilloma virus). HPV is a very common virus that can be passed on through any type of sexual contact with a man or a woman.

There are more than 100 types (strains) of HPV, many of which are harmless. However, some types can cause abnormal changes to the cells of the cervix, which can eventually lead to cervical cancer.

Two strains, HPV 16 and HPV 18, are known to be responsible for most cases of cervical cancer. They don't have any symptoms, so women will not realise they have it.

But these infections are very common, and most women who have them do not develop cervical cancer.

Using condoms during sex offers some protection against HPV, but it cannot always prevent infection because the virus is also spread through skin-to-skin contact of the wider genital area.

Since 2008, the HPV vaccine has been routinely offered to girls aged 12 and 13 but even with this vaccine you still need to have smear tests.

3) Symptoms of cervical cancer

Cancer of the cervix often has no symptoms in its early stages. If you do have symptoms, the most common is abnormal vaginal bleeding, which can occur during or after sex, in between periods, or new bleeding after you have been through the menopause.

Abnormal bleeding doesn't mean you have cervical cancer, but you should see your GP as soon as possible to get it checked out.

If your GP thinks you might have cervical cancer, you should be referred to see a specialist within 2 weeks.

4) Cervical cancer is the commonest cancer in women under the age 35yrs. There is an increased incidence in women age 25-29 years, and so it is important that all women, especially in this age group attend for their smears. 

5) Screening for cervical cancer

The best way to protect yourself from cervical cancer is by attending cervical screening (previously known as a "smear test") when invited.

The NHS Cervical Screening Programme invites all women from the age of 25 to 64 to attend cervical screening. Women aged 25 to 49 are offered screening every 3 years and those aged 50 to 64 are offered screening every 5 years.

National cervical smear coverage is only 72% and we need this to be higher to prevent these deaths 

During cervical screening, a small sample of cells is taken from the cervix and checked under a microscope for abnormalities. In some areas, the screening sample is first checked for human papilloma virus (HPV), the virus that can cause abnormal cells.

An abnormal cervical screening test result does not mean you definitely have cancer. Most abnormal results are due to signs of HPV, the presence of treatable precancerous cells, or both, rather than cancer itself.

You should be sent a letter confirming when it's time for your screening appointment. Contact your GP if you think you may be overdue.

6) all women must be aware at smear testing that HPV testing is done if there are minor cervical changes and if the HPV test is positive then they go on to have a colposcopy. The invitation for this may come before the results of the smear test.

7) A colposcopy is a simple procedure used to look at the cervix, the lower part of the womb at the top of the vagina. It's often done if cervical screening finds abnormal cells in your cervix.

These cells aren't harmful and often go away on their own, but sometimes there's a risk they could eventually turn into cervical cancer if not treated.

A colposcopy can confirm whether cells in your cervix are abnormal and determine whether you need treatment to remove them.

Useful Tips 

- A woman should stop HRT cream at least two days before having a smear

- If a woman is pregnant and invited for a smear, she should attend, purely so the cervix is looked at, but not in the first 6 weeks of pregnancy. However, no smear will be taken during pregnancy and will have to wait until the lady is at least 12 weeks postnatal.

There is an increased risk of cervical cancer with:

• the pill

• smoking, 

• multiple partners 

• not using condoms

• having a baby later in life 

• early age of first sexual intercourse 

There is a reduced risk of cervical cancer if you:

• Have regular smears 

• use condoms 

• stop smoking.

- Smears can be taken from 12 weeks after having a baby.

- Same sex partners also need to have smear tests taken.

In 2017 the UK National Screening Committee recommended that testing for HPV should replace cytology as the primary test in cervical screening. High Risk sub-types of HPV are linked to the abnormal cells and can cause cervical cancer. Evidence shows that HPV testing is a more effective way to identify women at risk of cervical cancer than by testing for abnormal cells from a PAP smear.

Doctor-led Cervical Smear service – combined cervical cytology & HPV test:

  • PAYG patients, £119.99 for 30-minute appointment and then £180 for the combined test
  • Members, £180 for the combined test