Cervical screening

Cervical screening is not a test for cancer. It is used to find early cell changes in the cervix, which may develop into cancer in the future.

Cervical screening uses a test called liquid-based cytology. This is often called a cervical smear.

In the UK, the NHS provides a cervical screening programme for all women who are registered with a GP. The ages when you are invited to attend, and how often screening happens, depends on where you live. England, Scotland, Wales and Northern Ireland all have national programmes with information about what cervical screening is and how it works.

For most women, cervical screening can prevent cancer. The cervical screening programme isn’t 100% effective, but regular cervical screening every 3–5 years is the best way to detect changes to the cells of the cervix.

Cervical screening is very effective at picking up early changes, but you should see your GP if you have any unusual symptoms, such as bleeding after sex or between periods.

Cervical screening and cancer

Cervical screening is not a test for cancer. It is used to find early cell changes in the cervix, which may develop into cancer in the future.

Cervical screening uses a test called liquid-based cytology. The doctor or nurse takes cells from the cervix and puts them into a fluid to preserve them. This is often referred to as a cervical smear.

NHS cervical screening (smear tests)

In the UK, the NHS provides a cervical screening programme for all women who are registered with a GP. The ages when you are invited to attend, and how often screening happens, depends on where you live. England, Scotland, Wales and Northern Ireland all have national programmes with information about what screening is and how it works.

Once women reach the age of 60–64 (depending on the country they live in), they are no longer invited to have cervical screening unless they’ve had recent cervical changes or haven’t been screened since they were 50. The reason for an upper age limit is because if the cells in the cervix are normal at this time, it’s very unlikely that a cancer will develop in later years. However, women aged 60 and over who’ve never had a screening test are entitled to have one.

Women under 25 (20 in Scotland) aren’t routinely screened as part of the screening programme because changes in a young woman’s cervix are quite normal. In this situation, screening may lead to unnecessary treatment. Research has also shown that screening women in their early 20s isn’t very effective at preventing cervical cancer.

Women who have never been sexually active have a very low risk of developing cervical cancer. However, although their risk is very low, there’s still a small possibility of cervical cancer so screening is still recommended. If you’ve never had sex you may choose not to be screened, and your GP or practice nurse can discuss this with you further.

Women who are no longer sexually active, but who were in the past, are still recommended to be screened when invited. This also applies to women who’ve been vaccinated against human papilloma virus (HPV). Women who’ve never had penetrative sex and women in same-sex relationships are also advised to be screened as they may still have been exposed to HPV.

Women of any age, who’ve had treatment for abnormal cells on the cervix within the last 10 years, may need to have a screening test more often. Your GP can discuss this with you.

Where to go for your screening test

You’ll be sent a letter from your local primary care support service or GP asking you to make an appointment for your screening test. Most women choose to have the test done by their practice nurse or GP. You can ask to have it done by a female doctor or nurse if you prefer.

Cervical screening tests can also be done at a family planning clinic, Well Woman clinic, sexual health clinic or a genitourinary clinic. Screening tests can also be done at private clinics.

‘I’m not embarrassed, and it’s not painful, it’s just one of those things you want to get done to make sure everything is all right.’ Cathy

Cathy


Can cervical screening prevent cancer?

For most women, cervical screening can prevent cancer. The cervical screening programme isn’t 100% effective, but regular cervical screening every 3–5 years is the best way to detect changes to the cells of the cervix.

How cervical screening can prevent cancer

Find out how regular cervical screenings (smear tests) can prevent cervical cancer.

About our cancer information videos

How cervical screening can prevent cancer

Find out how regular cervical screenings (smear tests) can prevent cervical cancer.

About our cancer information videos


Benefits and difficulties of cervical screening

Benefits

  • Cervical screening reduces the risk of developing cervical cancer.
  • The number of women who develop cervical cancer has halved since the 1980s due to most women regularly having cervical screening.
  • Cervical cancer is now an uncommon illness in the UK due to regular screening.
  • NHS cervical screening saves around 5,000 lives a year in England.

Difficulties

  • Cervical screening can show minor changes that may go back to normal on their own, but knowing they are there can be worrying.
  • Sometimes, too few cells are taken or the cells can't be seen properly and the test will need to be done again.
  • Regular cervical screening can prevent cancers from developing, but it doesn't prevent every case.
  • Cervical screening doesn't pick up every abnormality of the cervix.
  • Some women find the test an unpleasant experience.

What happens during cervical screening?

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos

What happens during cervical screening?

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos


Reliability of cervical screening

Cervical screening, like other screening tests, isn't perfect. So it is not always possible to detect early cell changes that can lead to cancer.

Abnormal cervical cells in your sample may not be recognised because:

  • sometimes they don't look very different from normal cells
  • there may be very few abnormal cells in the sample.

Occasionally, a test will have to be taken again because:

  • there may not have been enough cervical cells in your sample to give an accurate assessment
  • the sample may not have been properly prepared
  • the container your sample was put in may have been broken.

Although every effort is made to ensure the screening programme works properly, very occasionally mistakes happen. In recent years, the cervical screening programme has been improved so that mistakes are far less likely. All screening samples are now checked by two technicians so that the chance of missing an abnormality is greatly reduced.

Cervical screening is very effective at picking up early changes, but you should see your GP if you have any unusual symptoms, such as bleeding after sex or between periods. If you have symptoms, you may need to be referred for tests.

Back to Cervical screening and CIN

The cervix

The cervix is the lower part of the womb (uterus). It’s often called the neck of the womb.

Abnormal test results

If you have an abnormal result, this does not mean you have cancer. You may need some more tests.

Diagnosing and grading CIN

A colposcopy is used to confirm whether you have cervical intra-epithelial neoplasia (CIN) and how severe it might be.

Treating CIN

If you have been diagnosed with CIN, you may have treatment to remove the abnormal cells. There are different types of treatment.

After treatment for CIN

Most women feel fine after treatment for CIN but some may feel unwell for a few hours. You will be referred for regular screening tests.