This page is a selection of different questions that Jo’s Cervical Cancer Trust has received about cervical screening. The answers have been reviewed by Jo’s Cervical Cancer Trust medical advisers.

Around five million women have a cervical screening every year; 90 to 94% of whom receive a normal result. The procedure should not be painful but some women can experience a degree of discomfort and even short-term mild pain. Being screened, (especially if it's the first one) can be daunting for some, so it may help if you find out beforehand exactly what happens during a cervical screening appointment.

The appointment should take no longer than around 15 minutes with the procedure taking approximately three minutes. If you feel any pain and/or discomfort during the procedure please inform the GP/practice nurse.

Every woman's screening history is different and offering a cervical screening when she is (or might be) pregnant will be dependent on this history. If you have had abnormal result in the past or never had a cervical screening or had not attended previous invitations for screening, then you should consult your doctor or practice nurse to ask for advice.

Yes, all women regardless of their sexual preference who are over the age of invitation should have regular cervical screening. Most cervical abnormalities are caused by persistent infection with HPV. As HPV can be transmitted through skin-to-skin contact in the genital area, gay women are at risk of contracting HPV and experiencing abnormal cervical changes and thus, should always attend when invited for cervical screening.

A small minority of women may not need a cervical screening:

  • Women who have never been sexually active

The incidence of cervical cancer is extremely rare in women who have never been sexually active and the guidelines issued suggest that women who are sexually active attend for screening at the age of 25. More than 99% of cervical cancers are linked to infection with sexually transmitted HPV so it is recommended that if you have had sexual intercourse or genital-to-genital contact with a man or a woman, even just once, then you should attend for regular cervical screenings.
If you are not currently in a sexual relationship but have been in the past, you are recommended to have regular cervical screening.

  • Women over 65

Women aged 65 and over who have had three normal test results in a row are not called back for further cervical screening tests. It is very unlikely that women in this category will go on to develop cervical cancer.

If you are over 64 and have had abnormal results, you will continue to be invited for screening until the cells return to normal. Women aged 65 and over who have never had screening are entitled to a test.

If you have never had a screening test and have been sexually active, you should have a test, regardless of your age.

Some women who have had a hysterectomy are still thought to be at risk of developing abnormal cells and so should continue to have regular cervical screenings. For example if your womb was removed but you still have your cervix, you should continue to go for regular screening. If your womb and cervix were removed to prevent or treat cancer, you may still be asked to have a vaginal smear (vault smear) for a short period of follow up.

If your womb and cervix were removed for a benign (non-cancerous) condition, such as fibroids or heavy bleeding, you do not need to have any more cervical screenings. In general if you do not have a cervix, then you do not need to attend a cervical screening.

Cervical screening is 80% to 90% reliable and can prevent 60 to 80% of cervical cancers. This means that seven cases can be prevented out of every 10 women who would have developed cancer of the cervix [1].

There are several factors in the taking and reading of cervical screenings which makes it impossible to be 100% accurate. A cervical screening is a sample of cells taken from the surface of the cervix. Because it is only a sample, the cervical screening does not always accurately reflect what is occurring in the whole of the skin layer - and it is the latter which is important to make an accurate as possible diagnosis and of course attend screening when invited.

No. It is important to remember that cervical screening is a screening test and not designed to give a final diagnosis. It is used to detect early cervical cell abnormalities which, if left untreated, could lead to the development of cervical cancer at a time in the future. It is understandable to feel anxious if you receive an abnormal result but it is more important that you know and understand what the abnormality is so you can discuss the results with your doctor and arrange appropriate follow-up.

No. The vast majority of cervical screening results are normal but a very small percentage of the total screenings reported on every year are described as being either 'inadequate' or having a grade of abnormality. The majority of these abnormalities reflect pre-cancerous changes in the cells of the cervix, not cancer.

Almost all women will be infected with HPV at some point in their lives, but less than one in 10 will have an abnormal screening result. We do not know why this is. In some women it may be related to the immune system's ability to get rid of this virus quickly.

If cervical cell abnormalities have been detected this does NOT mean that you have cervical cancer or will get cervical cancer in the future. What it does mean is that some of the cells are slightly abnormal and that if left untreated could go on to develop into cervical cancer at a later date.

Medical research has yet to establish why some women have persistent HPV infection, develop abnormal cell changes, or cervical cancer.

No. Cervical screening is designed solely to detect early cervical cell abnormalities which, if left untreated, could lead to the development of cervical cancer at a time in the future. It is not designed to detect abnormalities in the ovaries, the womb, the vulva or the vagina. However, having a regular cervical screening does give the opportunity for the cervix to be examined.


References

  1. Sasieni et al. 2009. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 339, 1-7.

"FAQ on Cervical Screening." Jo's Cervical Cancer Trust. N.p., 19 Aug. 2013. Web. 02 Mar. 2015.