Cervical screening (smear test)

The cervical screening test (smear test) is designed to check your cervix (neck of the womb) for the Human Papilloma Virus (HPV).

If HPV is found, we’ll then look at the same sample for cell changes. HPV causes 99% of all cervical cancers.

Cervical screening can stop cervical cancer before it starts

Human papillomavirus (HPV)

Most changes in the cells of the cervix are caused by HPV.

It's very common, with 4 out of 5 people in Scotland catching it at some point in their lives.

As there are usually no symptoms, many people have it for months or years without knowing it.

Your body fights off most HPV infections naturally, but about 1 in 10 infections are harder to get rid of.

Find out more about HPV at Jo's Cervical Cancer Trust

Who'll be screened?

Cervical screening is routinely offered to women and anyone with a cervix in Scotland between the ages of 25 and 64.

Women on non-routine screening (where screening results have shown changes that need further investigation or follow up) will be invited up to 70 years of age.

Cervical screening for transgender and non-binary people

Do I need the test?

You should continue to have regular cervical screening, even if you:

• haven't been sexually active for a long time
• have been through the menopause
• have had the HPV vaccination
• are a lesbian or bisexual - HPV can be passed on through other forms of sexual activity

You might not need the test if you:

• have had a hysterectomy
• are pregnant
• have never been sexually active as there's less risk of you having HPV

If you get an invitation, speak to your nurse or GP.

Your screening invitation

When you get your invitation, read the information carefully and decide whether you want to take the test.

If you're unsure, look for further information to help you decide or talk to a trusted local health professional.

Appointments

Most women have the cervical screening test at their GP surgery. If you decide to take up the invitation, contact your GP surgery to arrange an appointment.

Try to make an appointment for a day when you won't have your period. During your period it's difficult to get a clear view of your cervix.

If you'd like to bring a friend, or arrange for an interpreter, mention this when making your appointment. You can also ask for a female nurse or GP.

Reducing your risk

Your risk of cervical cancer increases if you:

• are or have been sexually active
• smoke - as this makes the immune system less effective in fighting HPV

Sexual activity includes:

• penetrative sex
• skin to skin contact of the genital area
• using sex toys

More about the causes of cervical cancer

As with any test, there are benefits and risks involved in cervical screening (smear test). It’s important that you’re aware of these before you accept a screening invitation.

Benefits

There are usually no symptoms with HPV or changes in cervical cells and sometimes no symptoms with early stage cervical cancer.

Even if you have no symptoms, the smear test can help to find changes so that they can be monitored or treated.

Finding these changes at an early rather than late stage means:

• they're easier to treat
• you're 9 times more likely to survive cervical cancer

Risks

There are some risks to cervical screening:

• false positive results might wrongly show changes in your cervix (the neck of your womb)
• the test can sometimes miss changes in your cervix
• changes can also happen between screening tests

It’s important to go for a smear test every time you’re invited, and visit your GP as soon as possible if you:

• have unusual discharge
• bleed after sex or the menopause
• bleed between periods.

No screening test is 100% effective.

If you have:

• an unusual discharge
• bleeding after sex
• bleeding between periods
• bleeding after the menopause contact your GP practice.

These are usually caused by something other than cancer but it's important to have them checked.

More about the symptoms of cervical cancer.

The cervical screening test (smear test) involves taking a sample from your cervix (neck of your womb) and examining it for the presence of HPV.

You'll have the test at your GP surgery. The test usually takes no more than 5 minutes.

Before the test

At your GP surgery, a health professional will check your details and explain the test to you. You'll have an opportunity to ask questions.

If you’d like them to send your results to another address, please tell the person doing the test.

Your cervical screening appointment will last about 10-15 minutes from start to finish.

The test itself should take no longer than 5 minutes.

Taking the test

Before the test starts, you'll be asked to undress from the waist down (or just to remove your underwear if you're wearing a skirt. You'll also be given a sheet to cover yourself.

You'll be asked to lie on an examination bed. Your nurse or GP will gently insert a speculum into your vagina to hold it open so they can see your cervix.

They'll then gently brush cells from the cervix using a soft brush. You can ask for a smaller speculum if you feel any discomfort.

After the test

You’ll usually get your results in the post within 2 weeks. If you'd like these sent to another address, please tell the person doing the test.

The results will also be sent to whoever took your test and your GP.

If you haven’t received your results within 4 weeks, contact your GP practice.

Your test samples

Your cervical screening test sample is sent to a laboratory where it will be tested for HPV.

If HPV is found, the same sample will then be examined for cell changes.

It will be kept for at least 10 years to compare tests at different times.

You'll be contacted if the results suggest your care should be changed in any way.

Your sample may be tested again so the NHS can evaluate how well it's preventing cancer.

Your test results letter will show 1 of 4 possible results:

We found no HPV

Your risk of developing cervical cancer at this time is very low. We'll invite you for another routine screening test in 5 years.

We found HPV but no cell changes were seen

We'll ask you to come for another cervical screening test earlier than usual. This to check the HPV has cleared.

We found HPV and cell changes were seen

We'll ask you to come for further tests so we can take a closer look at your cervix. We'll let you know when you'll be invited for this.

Unclear result

Sometimes for technical reasons the lab can't get a result. We'll ask you to come back for another cervical screening test. This is nothing to worry about.

Colposcopy

A colposcopy is an examination of the cervix using a special microscope called a colposcope. The colposcope magnifies your cervix so that the specialist can see where the changes are and what they look like.

To do the test, the specialist will:

• gently insert a speculum into your vagina
• look at your cervix through the colposcope – it does not go inside you

Before the test, the specialist will explain what to expect and, if necessary, offer a local anaesthetic as it can feel a little uncomfortable.

More about how a colposcopy is performed.

Treatment

Sometimes treatment isn’t necessary. If this is the case the specialist will explain why and will arrange for you to have smear tests more often.

In some cases you’ll be asked to come back to the clinic for further colposcopy examinations. Your follow-up appointment will be with your specialist, nurse or GP.

If you’re unsure about anything or have questions about cervical screening, phone:

• your GP practice
• the NHS inform helpline

Cervical screening leaflets

Public Health Scotland has produced leaflets explaining cervical screening in Scotland, why it's offered and what happens next if the test finds changes that need further investigation.

A Smear Test Could Save Your Life leaflet

Your Smear Test Results leaflet

Your Smear Test After Treatment leaflet

These leaflets are also available in other languages and in Easy Read, British Sign Language (BSL) and audio format.