Cervical smear tests: your questions answered
What should you wear, how often should you get a smear, and what happens if you get an abnormal result? IMY BRIGHTY-POTTS gets the low-down
HAVE you ever wished you could ask more questions about cervical screenings or smear tests, but are worried you’ll sound silly?
The cervical screening programme helps save thousands of lives in the UK each year. But, it’s fair to say they can be a bit awkward or nerve-wracking for some people.
Remember, if you’re worried or unsure about anything, it is always absolutely OK to ask healthcare professionals for more information.
In the meantime, we asked experts to answer some of our most pressing questions about smear tests...
1. What age can you stop having screenings?
Amanda Caley, clinical specialist for Zilico, who works across 15 hospitals across the UK in colposcopy, says: “The UK has one of the most robust screening programmes in the world, and at 64 you go for your last annual screen if there are no abnormalities.”
Professor Jay Chatterjee, consultant gynae-oncologist at The Lister Hospital, part of HCA Healthcare UK, notes that “the risk of cervical cancer significantly decreases after the age of 65 years”.
2. How often should I go for a smear test?
When it comes to routine cervical screenings, Amanda explains that how frequently they are offered “isn’t the same across the UK.
“In England, we start at 25 and until you are 49, you get screened every three years. If there is an issue you may have to be screened more frequently.”
However, in Wales, routine screening has been extended to every five years instead of three.
It’s every five years in Scotland, too.
For people who don’t identify as female but may still need screenings, Amanda says: “If you aren’t registered as a female with your GP but have a cervix, do phone your GP service and ask to join the list.”
3. Can you book a cervical screening at any time?
Amanda says: “You can’t do it at anytime. It has to be your turn, you can’t call at 19 and ask for a screening.”
Prof Chatterjee adds: “Unless there is a medical reason as to why you need a smear test before 25, they are not routinely carried out until this age, as the risk of cervical cancer is very low.”
However, if you are concerned about any unusual symptoms or have a family history of cancer, speak to your GP.
They can answer any questions you have, and provide personalised advice and reassurance. 4.
How worried should you be if you’re called in for a biopsy?
First and foremost, getting an abnormal result on your smear test does not mean you have cancer.
Cervical screenings don’t diagnose cervical cancer. They’re designed to prevent cancer from happening – by checking for certain strains of HPV and cell changes, which may mean you’re at greater risk of developing the disease. These can then either be monitored or treated, as required.
If cell changes are detected during your screening, the next step is usually a colposcopy, which enables a healthcare professional to take a closer look at your cervix. If necessary, a small sample of cells (biopsy) may be taken for further testing.
“A colposcopy will take place in a hospital setting, but the nurses will try their best to make you comfortable,” says Amanda. “You will be assessed there, answer some questions and sit in a chair with stirrups.
“There will be a few dyes used to change the colour of the cells to see if everything is normal. If all of those things are indicating you need a biopsy, then you would [have one].”
5. What should you wear for a smear test?
You can wear anything you like – but for practicality and comfort, Amanda says: “Don’t wear a big jumper, or a jumpsuit. You look fab but you will end up sat in your bra. Wear a nice maxi dress or some joggers. Make it easy to get on and off.”
6. How many tests do you do in a typical day?
This depends on the clinic, but Amanda says: “Within primary care in a GP surgery, the nurse will do up to 10 people in the morning in a smear clinic, but it does vary.”
7. Is there any body judgement?
Amanda is adamant: “No!” she assures. “We have seen everything and we couldn’t pick you out of a crowd after. The clinics tend to be more female-led, which may put you more at ease. We are just in there to have a look at your cervix.”
8. Is it easier to do a screening post-birth or during menopause?
“No, it is just different. In reality, there are five different types of speculums you might use and you will be assessed based on what makes you comfortable. We can use a very small speculum if it will make you more comfortable,” explains Amanda. Prof Chatterjee adds: “It is advised you wait at least three months after giving birth before booking a smear test.
“In menopausal women, using vaginal oestrogen can make getting an adequate smear easier.”
9. Will it be uncomfortable after?
“It normally doesn’t, but everyone is different,” says Amanda. While many people experience no physical discomfort after a smear, some people may do – and it’s OK to tell your nurse or doctor if you are anxious.
“If you tense up, it will be more uncomfortable. Take a paracetamol beforehand if you are really worried. Take a deep breath, and breath out as the speculum comes out,” Amanda advises.
10.
“If you want to, yes, if you generally like to, but you don’t need to for your screening,” says Amanda.
“It makes no difference to us if you are hairy or hair-free.”
11.
Should I wax or shave before?
While many people experience no physical discomfort after a smear, some people may do – and it’s OK to tell your nurse or doctor if you are anxious Amanda Caley from Zilico, above
Can I have my screening if I am on my period?
“Not really,” says Amanda. “Cells from the lining of your womb are coming away and those cells are not being looked for. Call and ask beforehand.”
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