Cervical screening (smear test) is a quick test to check your cervix (neck of the womb) for the Human Papilloma Virus (HPV).
HPV is a common virus that can cause many different types of cancer. HPV causes 99% of all cervical cancers. Your sample is checked for HPV that can cause cell changes.
Having both the HPV vaccination and cervical screening will dramatically reduce the number of people with cervical cancer in Scotland.
If you have symptoms of coronavirus, or have been in contact with someone who does, you should not go to your cervical screening appointment. Contact your GP practice and let them know. They can rearrange your appointment for after your isolation period.
Cervical screening exclusion error
NHS Scotland has identified a number of people who may have been incorrectly excluded from cervical screening following a hysterectomy. Anyone affected by this error will be contacted by the NHS.
How often will I be invited for cervical screening?
Testing for HPV is an effective way of identifying those at risk of developing cervical cancer. HPV can go on to cause cell changes which, if left untreated, could lead to cervical cancer in around 10 to 15 years' time.
That's why, if no HPV is found, you'll be invited for your next cervical screening appointment in 5 years' time, regardless of age. This is because evidence has shown your chance of developing cervical cancer in this time is very low.
Changes to screening intervals in Scotland
In March 2020, the routine screening interval for women and anyone with a cervix aged 25 to 49 changed from 3 years to 5 years. This change happened at the same time as HPV testing was introduced in Scotland.
Testing cervical screening samples for HPV first is more sensitive and accurate.
It's safe to wait for 5 years between screening tests if no HPV is present because your chance of developing cervical cancer during this time is very low.
Once you've been invited for an HPV test, your screening interval will be changed from 3 to 5 years.
The routine cervical screening interval for people aged 50 to 64 hasn't changed and you'll still be invited every 5 years if you're within this age range.
You may need to have screening more often depending on your test results.
Do I need to have cervical screening?
You should continue to have regular cervical screening, even if you:
haven't been sexually active for a long time
have been through the menopause
have had the HPV vaccination
have had a subtotal hysterectomy - the removal of your womb (uterus) but you still have a cervix
are a lesbian or bisexual - HPV can be passed on through other forms of sexual activity
You might not need cervical screening if you:
have had a total hysterectomy (removal of both womb and cervix)
are pregnant and up to 12 weeks after birth
have never been sexually active as there's less risk of you having HPV
If you get an invitation and aren't sure that you need cervical screening, speak to your nurse or GP.
If I’ve had a hysterectomy, do I still need to be invited for cervical screening?
If you’ve had a total or radical hysterectomy, your womb and cervix will have been completely removed. Your consultant gynaecologist will make sure you have a follow up, if needed. You’ll be removed from the cervical screening programme, so you’ll no longer receive invitations.
If you’ve had a subtotal hysterectomy, only your womb will have been removed. This means you should still be invited for cervical screening as part of the Scottish cervical screening programme.
Watch this short film by Jo's Cervical Cancer Trust about having a smear test.
Your screening invitation
When you get your invitation, read the information carefully and decide whether you want to take the test.
It’s normal to feel anxious, especially at your first appointment. Don’t let it put you off. Talk to your GP or nurse as they can help with any concerns, embarrassment or past experiences.
Most people have the cervical screening test at their GP surgery. If you decide to accept the invitation, contact your GP surgery to arrange an appointment.
Try to make an appointment for a day when you won't have your period. During your period it's difficult to get a clear view of your cervix.
You can ask for extra support for your appointment. For example, you can ask for a translator, female nurse or GP. You can also book a longer appointment if you'd like a bit more time to talk things through.
Cervical screening after experiencing sexual violence
The thought of cervical screening can feel traumatic or distressing if you've experienced sexual violence. There are ways that the NHS can support you. For example, you can request a double appointment, take someone you trust to the appointment, or access a specialist clinic.
Watch this film by Jo's Cervical Cancer Trust to find out what cervical screening test results mean.
A colposcopy is an examination of the cervix using a special microscope called a colposcope. The colposcope magnifies your cervix so that the specialist can see where the changes are and what they look like.
To do the test, the specialist will:
gently insert a speculum into your vagina
look at your cervix through the colposcope – it does not go inside you
Before the test, the specialist will explain what to expect and, if necessary, offer a local anaesthetic as it can feel a little uncomfortable.