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BHWC are encouraging patients to book in for your smear tests! During Cervical Cancer Prevention Week, we want to remind you how you can reduce your risk of the disease. You may be unsure whether the pandemic means attending your cervical screening is a priority, well yes, it is! We are still carrying out smears at BHWC and we would encourage you to attend if you have received an invitation. The easiest way to book your appointment is online using systemonline or via the airmid app. If you do not know your login details you can request them here.

What is cervical screening?

Cervical screening is a free health test that helps prevent cervical cancer. It checks for a virus called high-risk human papillomavirus (HPV) and, if you have HPV, cervical cell changes (abnormal cells).  It is not a test for cancer.

It is your choice whether to go for cervical screening. We hope this information helps you make the best decision for you and your health.

If you have symptoms, contact your GP surgery about having an examination. Cervical screening is not for people who have symptoms.

There is no difference between cervical screening and a smear test. They are two different names for the same test. A smear test is the older name for the test. It was called that because of the way the test used to be done – cells were smeared on a glass slide, which was sent to the laboratory for testing. The test is different now and most healthcare professionals call it cervical screening. Your letter will invite you to attend cervical screening, which is why we call it that in our information.

Who is invited for cervical screening?

You should be invited for cervical screening if you have a cervix. Women are usually born with a cervix. Trans men, non-binary and intersex people may also have one. You will automatically be invited for cervical screening 3 years if you are age 25 to 49 and every 5 years if you are age 50 to 64 and registered as female with a GP surgery in UK. At BHWC we run a trans health hub and we have additional processes in place which ensures we invite our male patients who may have a cervix. For more information, read about cervical screening for LGBT+ patients. It is rare to develop cervical cancer under the age of 25 and over the age of 64, if you have had regular cervical screening. You can book an appointment as soon as you get the invite.

What are the benefits and risks of cervical screening?

You are invited for cervical screening because evidence shows that the benefits of the test outweigh any risks. Along with the HPV vaccine, cervical screening is the best way to protect against cervical cancer and prevents over 7 in 10 diagnoses. However, like any screening test, cervical screening is not perfect and there are some risks.

Benefits of cervical screening

Cervical screening aims to identify whether you are at higher risk of developing cervical cell changes or cervical cancer. This means you can get any care or treatment you need early.

England, Scotland and Wales now use HPV primary screening, which is even better as it is based on your individual risk. This means how frequently you are invited for cervical screening is based on your last result and within a timeframe that is safe for you.

Possible risks of cervical screening

In a few cases, cervical screening will give an incorrect result. This means it may say someone does not have HPV or cell changes when they do (a false negative). Going for cervical screening when invited can help reduce this risk, as it is likely HPV or cell changes that were missed would be picked up by the next test. It also means a result may say someone does have HPV or cell changes when they do not (a false positive), which could mean they are invited for tests or treatment they do not need.

Sometimes cell changes go back to normal without needing treatment. At the moment, we cannot tell which cell changes will go back to normal, so treating means we can be sure we are preventing them from developing into cervical cancer. This means some people may have unnecessary treatment, which is called overdiagnosis or overtreatment. Using HPV primary screening should help prevent this.

It is hard to know exactly how many people are affected by these risks. But we do know, for those aged 25 to 64, the benefits of cervical screening outweigh the risks and most results will be clear.

Do I need cervical screening after a hysterectomy?

If you have previously had treatment that affected your cervix for any reason, you may no longer be invited for cervical screening. These treatments include:

A hysterectomy. This is an operation that removes the womb and cervix. If you have had a hysterectomy, you will not be invited for cervical screening as there is no cervix to take a sample of cells from.

Pelvic radiotherapy. This is a treatment that directs radiation at the part of the body between the hipbones (pelvis). It can damage the cells of the cervix and make it harder to tell if there are any changes, so you may not be automatically invited for cervical screening. Your doctor may do a separate follow up appointment with you.

After these treatments, your healthcare team may want you to have a different test called a vault smear. This takes a sample of cells from your vagina and tests them to check that they are healthy. Whether you are offered vault smears and how long you are offered them for depends on your individual situation.

Should I go for cervical screening if I am pregnant?

It is usually recommended that you do not have cervical screening while you are or could be pregnant. Pregnancy can make the result of your test harder to interpret.

If you are invited for cervical screening while pregnant, tell your doctor or nurse you are pregnant. You should wait until 3 months after your baby is born to have the test.

If you need follow-up after an abnormal cervical screening result or treatment for cell changes, you may need to have the test while pregnant. Your GP or midwife may ask you to have it at your first antenatal appointment. This test will not affect your pregnancy.

Should I go for cervical screening if I am pregnant?

Ask your doctor or nurse if you are up to date with your cervical screening. This means that any tests or treatment can be arranged around the pregnancy.

Should I go for cervical screening if I have HIV?

HIV can make your immune system very weak, meaning it is not as able to get rid of HPV that causes most cervical cancers. If you have HIV, speak with your healthcare team about going for cervical screening every year. Annual cervical screenings are usually taken outside of the NHS National Screening Programme.

What happens at cervical screening?

At your cervical screening (smear test) appointment, a nurse takes a sample of cells from your cervix using a small, soft brush. The test only takes a few minutes.

If you feel worried about going for cervical screening, you are not alone. It may help to know as much as possible about what going for cervical screening is like.

What happens during your smear test?

Your nurse will give you a private space to undress from the waist down, usually behind a curtain. If you are wearing a dress or skirt, you can leave this on and just take off your underwear. Your nurse will ask you to lie on an examination bed and give you a new, clean paper sheet to cover the lower half of your body. You can lie on your back with your legs bent up, your ankles together and your knees apart or on your left side with your knees bent.

Your nurse will let you know when the test is about to start. First, they gently put a new, clean speculum into your vagina. A speculum is usually a plastic cylinder with a round end – sometimes a metal speculum is used. The speculum is the part that some people find uncomfortable. Once the speculum is inside your vagina, the nurse will gently open it so they can see your cervix.  Then the nurse will use a small, soft brush to quickly take a sample of cells from your cervix. This may feel a bit strange but should not be painful.

The nurse will put your sample of cells into a small plastic container (vial) of liquid. The liquid preserves the cells so they can be sent to a lab for testing. And that’s it! The nurse will take the speculum out of your vagina and give you a private space to dress again. They will explain how and when you should get your results.

After your cervical screening appointment

Most people can continue their day as usual after the appointment. Once you are home from your appointment, it is important to follow the government guidance about washing your hands and any face coverings. You may have some light bleeding (spotting) for a day after the test, so it can help to wear a sanitary pad or panty-liner. Your cervical screening results should arrive by post within 4 weeks.

Book your appointment

When you receive your invitation, you can book your appointment online using systemonline or via the airmid app. If you do not know your login details you can request them here.