Do I really need to get a smear test?
200% yes. Yes yes yes. If you have received your letter inviting you to a smear test, you absolutely should go.
What are they for?
Smear tests (also called cervical screening and PAP tests) are not a test FOR cancer, but actually a way to help PREVENT cancer. They look for any cells on your cervix that contain a certain strain of human papillomavirus (HPV). (HPV has lots of strains, some can cause genital warts, some can cause cervical cancer etc.) Smear tests look for certain strains of HPV. These types of HPV can cause abnormal changes to the cells in your cervix and are called "high risk" types of HPV.
If these types of HPV are found during your screening (an HPV positive result), the sample of cells is then checked for abnormal changes.
If left to their own devices, cells containing these high risk HPV cells may turn into cancer in the future. Having a smear test can alert doctors to those abnormal cells BEFORE they turn into cancer.
How do you get cervical cancer?
Nearly all cases of cervical cancer are caused by infection with a high risk HPV. HPV is super common and over 90% of sexually active people will have it at some point in their lives. It comes from any type of sexual contact and even wearing a condom may not protect you as it can be transferred from skin to skin. This means anyone with a cervix who has had some kind of sexual contact is at risk of cervical cancer, including lesbians, trans men (with a cervix) and people who have been sexual but not had penetrative sex. In most cases, your body will fight the HPV off within a year or two and everything is fine. As it is so prevalent, it is really important to go for your smear test.
Cervical cancer is quite slow growing, often taking around 5 - 10 years to develop. This is why the gap between each smear is 5 years, unless you have HPV or abnormal cells, in which case you will be screened more regularly to keep an eye on things.
What happens during a smear?
You'll be asked to remove your clothes from the waist down and often given a sheet to cover yourself with.
You'll be asked to shuffle your bum to the end of the table and let your knees flop open.
The nurse or doctor will then insert a speculum (the device that opens up the walls of your vagina so they can get access to the cervix at the top of your vagina).
Once the speculum is in, they will use a small soft brush to gently scrape away some cells from your cervix for testing. This takes only a few seconds and can feel uncomfortable and unusual.
They'll then remove the brush and the speculum and you're done.
The cells will be sent off for testing and you'll get your results back usually within a month. If everything looks fine, you'll be asked to return for another smear in 5 years time. If something needs further investigation you'll usually be asked to go for a colposcopy. This is a closer look at your cervix to see what is happening and if any further treatment needs to happen.
Smear tests can range from being totally fine, to a bit uncomfortable to quite painful for some people. Here are some tips to make it a bit easier if you find it difficult.
As hard it sounds, try and relax. If you're tense, it will make the examination a bit more uncomfortable. Deep breaths are good.
Tell the doctor or nurse that you are nervous and can they please talk through what they are doing (if that will help you) and go slowly.
You can ask to insert the speculum yourself. This can be a good option for anyone who has been through any sexual trauma.
Bring a friend or family member with you to hold your hand and help you stay calm.
Remember, it will be over in a minute or two. It's a very quick procedure.
Smear tests can save your life. A few minutes of feeling uncomfortable could stop you from developing cervical cancer.
If that letter is sitting around at home, please ring up and book your test today.
For more information, including a video of how the smear test happens, please see the NHS Cervical Screening pages.