Overview

The cervical screening test (smear test) is designed to check cells from your cervix (neck of the womb) for any changes so that they can be monitored or treated. 

Without treatment these changes can sometimes develop into cervical cancer. 

Cervical screening can stop cervical cancer before it starts

Who's at risk?

Cervical cancer is the most common cancer in women aged 25 to 34 in Scotland.

Your risk of cervical cancer increases if you:

  • are or have been sexually active
  • smoke - as this affects the cells in your cervix

Sexual activity includes:

  • penetrative sex
  • skin to skin contact of the genital area
  • using sex toys

More about the causes of cervical cancer

Human papilloma virus (HPV)

Most changes in the cells of the cervix are caused by a type of virus called the human papilloma virus (HPV) passed on through sexual contact.

HPV is very common – 8 out of 10 people in Scotland will catch it at some point in their lives.

As there are usually no symptoms, many people have it for months or years without knowing it.

Your body fights off most HPV infections naturally, but about 1 in 10 infections are harder to get rid of.

Who'll be screened?

Cervical screening is routinely offered every:

  • 3  years to women aged between 25 and 49 years of age
  • 5 years to women aged between 50 and 64

Women on non-routine screening (where screening results have shown changes that need further investigation or follow up) will be invited up to 70 years of age.

Do I need the test?

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
  • are a lesbian or bisexual - HPV can be passed on through other forms of sexual activity

You might not need the test if you:

  • have had a hysterectomy
  • are pregnant
  • have never been sexually active as there's less risk of you having HPV

If you get an invitation, speak to your nurse or GP.

Your screening invitation

When you get your invitation, read the information carefully and decide whether you want to take the test.

If you're unsure, look for further information to help you decide or talk to a trusted local health professional.

Appointments

Most women have the cervical screening test at their GP surgery. If you decide to take up 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.

If you'd like to bring a friend, or arrange for an interpreter, mention this when making your appointment. You can also ask for a female nurse or GP.

Guide to cervical screening (https://www.youtube.com/watch?v=Ej_Pci-W6Hk)

Watch this short film by Jo's Cancer Trust about having a smear test.

Benefits and risks

As with any test, there are benefits and risks involved in cervical screening (smear test). It’s important that you’re aware of these before you accept a screening invitation.

Benefits

There are usually no symptoms with changes in cervical cells and sometimes no symptoms with early stage cervical cancer.

Even if you have no symptoms, the smear test can help to find changes so that they can be monitored or treated.

Finding these changes at an early rather than late stage means:

  • they're easier to treat
  • you're 9 times more likely to survive cervical cancer

Cervical screening saves around 5,000 lives every year in the UK and prevents 8 out of 10 cervical cancers from developing.

Risks

There are some risks to cervical screening:

  • false positive results might wrongly show changes in your cervix (the neck of your womb)
  • the test can sometimes miss changes in your cervix
  • changes can also happen between screening tests

It’s important to go for a smear test every time you’re invited, and visit your GP as soon as possible if you:

  • have unusual discharge
  • bleed after sex or the menopause
  • bleed between periods

More about the symptoms of cervical cancer

Taking the test

The cervical screening test (smear test) involves taking cells from your cervix (neck of your womb) and examining them for changes.

You'll have the test at your GP surgery. The test usually takes no more than 5 minutes.

Before the test

At your GP surgery, a health professional will check your details and explain the test to you. You'll have an opportunity to ask questions.

If you’d like them to send your results to another address, please tell the person doing the test.

During the test

Before the test starts, they'll offer you a sheet or blanket to cover yourself. If they don't, you can ask for one.

When you're ready, they'll ask you to:

  • undress from the waist down or just remove your underwear if wearing a skirt
  • lie on your back on an examining bed
  • bend your knees

They'll then insert a speculum into your vagina to hold it open and use a soft brush to collect a sample of cells from your cervix.

After the test

After your test, the health professional will send your cells to a laboratory for examination.

You’ll usually get your results in the post within 4 weeks. They'll also send your results to your GP and whoever took your test. If you haven’t received your results within 4 to 6 weeks, contact the person who carried out your test.

Your test samples

The laboratory will keep your test sample for up to 10 years to compare samples taken from different times. They'll contact you if your results suggest you need to be monitored or treated.

The laboratory might also test your sample for human papilloma virus (HPV). This will help to measure how well we prevent cervical cancer caused by HPV.

Test results

You’ll usually get your results in the post within 4 weeks. They'll also send your results to your GP and whoever took your test. If you haven’t received your results within 4 to 6 weeks, contact the person who carried out your test.

Your test results letter will show 1 of 4 possible results:

  • no changes to your cells
  • not enough cells to test
  • minor changes to your cells
  • changes which require further investigation

No changes to your cells

In 9 out of 10 cases, there will be 'no changes' and you’ll be invited to have another smear test in 3 or 5 years as usual.

Not enough cells to test

Sometimes there aren't enough cells in the sample to examine. This isn't unusual and you’ll be invited to repeat the test in 3 months’.

Minor changes

Minor changes sometimes clear up on their own and don't need any treatment.

These changes will be monitored to check that they've cleared up.

You’ll be invited to have another smear test in a few months’ time.

Changes which require further investigation

For the 1 in 10 women who have changes, treatment will usually be for changes to the cells before they turn into cancer. Any treatment you may need is usually simple and you can almost certainly be treated as an outpatient.

If changes are detected which need further investigation you’ll be referred to a colposcopy clinic for examination to check whether the changes need to be monitored or treated.

Colposcopy

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.

More about how a colposcopy is performed

Treatment

Sometimes treatment isn’t necessary. If this is the case the specialist will explain why and will arrange for you to have smear tests more often.

In some cases you’ll be asked to come back to the clinic for further colposcopy examinations. Your follow-up appointment will be with your specialist, nurse or GP.

Further information

If you’re unsure about anything, or have any questions about cervical screening, phone:

Leaflets

NHS Health Scotland have produced leaflets explaining cervical screening in Scotland, why it's offered and what happens next if the test finds changes that need further investigation.

These leaflets are also available in Easy Read English and other languages - including Polish, Simplified Chinese and Urdu.

NHS Health Scotland: A Smear Test Could Save Your Life leaflet

NHS Health Scotland: Your Smear Test After Treatment leaflet

NHS Health Scotland: Your Smear Test Results leaflet

British Sign Language (BSL) leaflets

NHS Health Scotland have produced BSL versions of these leaflets.

A Smear Test Could Save Your Life (https://www.youtube.com/watch?v=N1l5XHODBRI)

Find out about the importance of smear tests, who they're for and what'll happen at your smear test appointment.

Your Smear Test After Treatment (https://www.youtube.com/watch?v=xJZjl0oVrCs)

Information about smear tests following cervical intraepithelial neoplasia (CIN) treatment.

Your Smear Test Results (https://www.youtube.com/watch?v=8mZOLvSG4vQ)

Information on what results you can receive following a smear test.