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A cervical smear test is a simple test to check the health of your cervix, the opening to the uterus from the vagina. A smear test involves taking a sample of cells from your cervix in order to test for certain types of human papillomavirus (HPV). These particular strains of HPV can cause changes to the cells in your cervix. A cervical smear aims to catch these cell changes and treat them before they turn into cervical cancer.
Depending on the results of the test, you may be asked to return for a follow up smear test in three months time, one year’s time or three to five years time if no HPV is detected in your sample. Sometimes you may be asked back for a colposcopy, a procedure where a microscope is used to have a closer look at the cervix. It is worth bearing in mind that in most cases, HPV is not found (known as a HPV negative result).
Although a cervical smear test may sound daunting, it is the best way of detecting and preventing cervical cancer.
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A cervical smear test is the best way to protect yourself from cervical cancer. Although a smear test is not a test for the cancer itself, it detects the presence of high-risk HPV strains and abnormal cells. If these abnormal cells are treated promptly, this prevents them from developing into cervical cancer.
If you have a cervix and have previously had any sexual contact with a man or a woman, you are at risk of cervical cancer. It doesn’t matter whether you have had one or many partners or whether you have had penatrative sex or not.
All women between the ages of 25 and 64 and anyone else with a cervix, including transmen, should have regular smear tests.
If you are under 25, you should have a smear test up to six months before you turn 25. Women aged 25 to 49 should attend for cervical screening every three years, those aged 50-64 every five years.
If you are 65 or older, you only need to have a smear test if one of your last three tests came back as abnormal.
A smear test is a quick procedure and takes just five minutes to carry out.
You will be asked to undress from the waist down behind a screen and lay down on a surgical couch. You will be given a sheet to put over your lap.
Once you are ready, the doctor or nurse will ask you to bend your legs, put your feet together and push your knees apart. Lubricant will be applied and a smooth surgical tool called a speculum will be put in your vagina to hold it open, allowing the doctor or nurse a clear view of your cervix. A soft brush will be swept around the cervix to take a cell sample and the speculum is then removed. If required, you will be given some tissue to wipe away any excess lube before getting dressed behind a privacy screen.
You can always ask the doctor or nurse to use a smaller speculum if required or ask about lying in a different position, such as on your side with your knees pulled to your chest, if you find this more comfortable.
Some women find it more comfortable to wear a dress or skirt during the test.
Once you have had your smear test, the doctor or nurse will let you know when you can expect your results.
Most people will receive a negative result, meaning the risk of cervical cancer is very low. You don’t have to do anything and will be invited back for screening in three to five years time.
If HPV is found in your smear test sample, you will need further tests. If HPV is found, but there are no abnormal cells present, you will be asked to come back for another smear test in one year’s time. If HPV is still present then, you will come back a year later for another test. If there is still HPV present after three years, then you may need a colposcopy for further investigation.
If your sample tests positive for HPV and abnormal cells are also detected, then you will be asked to have a colposcopy, where a microscope is used to take a closer look at the cervix.
Sometimes you will get what is known as an inadequate result. This is nothing to be alarmed about, it just means that the results were unclear. If you have an inadequate result you will be invited back for another smear test in three months.
If abnormal cells are found, the doctor will carry out a colposcopy, a procedure where a microscope is used to have a closer look at the cervix. During this investigation, the doctor or specialist nurse may take a sample (biopsy) of the abnormal cells. You may be offered treatment at the same time. There are several different treatments for abnormal cells.
The most common method of removing these cells is by large loop excision of the transformation zone (LLETZ). This procedure uses a thin wire loop that's heated with an electric current to remove the affected cells. It takes around five to 10 minutes and you can go home on the same day as the procedure. Local anaesthetic is used to numb the area, although you may experience some mild pain or cramping after LLETZ.
The procedure may take longer if a larger area of the cervix needs to be treated and a general anaesthetic may be used. Alternatively, a cone biopsy may be carried out if a larger area is being treated. This involves removing a large cone-shaped piece of tissue via laser or scalpel. This is carried out under a general anaesthetic.
Other treatments include cryotherapy (freezing and destroying abnormal cells), laser treatment (a laser is used to pinpoint and destroy abnormal cells), cold coagulation (abnormal cells are burned away) and a total hysterectomy (only considered if abnormal cells have been detected more than once or if cells are severely abnormal).
Very occasionally, the colposcopy and biopsy will detect cervical cancer. If this is the case, you will be referred to a team of specialists and cancer treatment will begin as soon as possible. Having a colposcopy does not necessarily mean that you have cervical cancer.
We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.
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We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journeyThe Patient Journey
Is a smear test painful?
For most people, a smear test is not painful. You may experience mild discomfort and some light spotting or bleeding immediately after your test.
Some women with certain medical conditions (eg vaginismus) or victims of FGM or sexual violence may find a smear test painful. If this is the case, tell the nurse before the screening. They will be able to help, for example by offering a smaller-sized speculum if appropriate.
When can I expect the results of my smear test?
You will get your smear test results in the post. This may take anywhere between two to six weeks. If this is taking longer, you should contact your doctor to find out if they have any updates and when you are likely to hear.
I’ve been vaccinated against HPV. Do I still need cervical screening?
Although the HPV vaccine protects you from a number of different types of HPV, it will not protect you from every strain of the virus. So even if you have been vaccinated, you should still attend your regular cervical screening appointments.
How should I prepare for a smear test?
When booking a smear test, you should avoid making an appointment during your period. Try to avoid the two days before and after your bleed. If you are having treatment for a pelvic infection or unusual vaginal discharge, don’t book an appointment until the treatment has finished.
Avoid using vaginal lubricants, creams and medicines during the two days before the test as these can affect your smear test results.
Can I arrange a smear test privately?
Yes, you can book a private cervical smear test in the UK if you want to have more frequent tests than those offered by the NHS. Contact the Cadogan Clinic for more information about booking a private cervical smear test in London.
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