Smear Tests

What is a Cervical Screening Test (smear Test)?

The cervical screening smear test checks to see that the cells  on the skin of  the neck of the womb (the cervix) are developing normally. These changes are so small they can only be seen under a microscope. The test can identify abnormal changes in the cells called dyskaryosis. These abnormalities are an early warning sign, indicating that cancer may develop in years to come. Fortunately, these abnormalities can be treated simply and effectively and stop cancer.


ARE SMEAR TESTS GUARANTEED TO STOP WOMEN GETTING CANCER?

Regular smear tests prevent 80 – 90% of the cancers that would occur if they weren’t done. Smear tests can’t prevent all cancers

WHO NEEDS CERVICAL SMEAR TESTS?

Any woman aged between 25 and 65 is invited to have a cervical screening test

Cervical screening used to start age 20- why has it changed?

A review of the scientific evidence  showed that that screening women below the age of 25 has little or no impact on rates of invasive cervical cancer.

Cervical screening used to stop age 60- why has it changed?Scientific evidence shows that women up to the age of 64 helps prevent cancer. In women aged over 50 , screening every five years offers adequate protection.

When did the age range change?

Monday 6th June 2016. anyone who was 20 before this date will have been offered a smear test, anyone who was 20 after this date won’t be offered a test until they are 25.

I’m worried about cervical cancer because I have bleeding/ a discharge. Should I get a smear test?

A smear test is for people with no symptoms. If you have symptoms speak to your doctor

I’ve had the HPV jab- do I need a smear test?  Yes

The current HPV vaccine does not protect against all types of HPV so although the vaccine offers good protection, the combination of immunisation and regular screening offers the best protection against cervical cancer.

HOW OFTEN SHOULD I HAVE A SMEAR?

In Scotland, women  aged 25-50 are recommended to have a smear every 3 years, and women aged 50-65 every 5 years. You will be reminded with a letter that this is due

WHERE CAN I HAVE A SMEAR TEST?

You can choose where to go. Most women go to their GP practice (where they are usually taken by the practice nurse).. You can also go to a sexual health clinic. Your GP will be informed of the result if the test is taken elsewhere.

WHAT HAPPENS WHEN A SMEAR IS TAKEN?

You will need to take off your tights and pants. If you are wearing a skirt it can usually be kept on. You will then be asked to lie on a couch and to bend your knees. The doctor or nurse will use a special tube called a speculum to see the cervix. This slides into the vagina (the opening that leads to the cervix, the “front passage”). The speculum holds the walls of the vagina gently apart so that the cervix can be seen. A small, specially shaped plastic brush is rubbed on the cervix to collect some of the cells from the surface. The brush is swished in a liquid, which is then sent to the laboratory and examined under a microscope. it is normal to have a little bit of bleeding when a smear test is taken.

Can I have a smear test if I have my period?

It is best to avoid the days when you have a period as the blood can obscure the view of the cells the lab are looking for.

Does it hurt?

Most women say that it does not hurt. Sometimes there is a little discomfort. Some women feel embarrassed or anxious about having a smear taken. We understand this. Remember that the doctor or nurse take smears all the time! They respect your feelings and will try to make things as easy as possible for you. Tell them if you are feeling nervous and they will help you relax

WHAT HAPPENS WHEN I GO FOR A SMEAR TEST?

To see and understand what happens when you go for a smear test, click here.

HOW WILL I GET THE RESULT?

You should be sent a letter giving you the result of your smear. The letter will tell you when your next smear is due or if you need an appointment for a check-up at a coposcopy clinic. The smear taker also gets a copy of the result.  If you have not had your result within 4 weeks of the smear being taken, please contact the place where the smear was done.

Please make sure that your smear taker has your correct address to send your result to.

If you want to speak to someone after you get your result, contact your GP surgery or the sexual health service (01294 323228/6).

WHAT ABOUT THE RESULT?

For most women the smear test gives a normal result, meaning that the risk of them developing cervical cancer is very low. However, if you have abnormal bleeding (for example in between periods or after sex) or a smelly discharge, it is important to get a check up from a doctor.

Other results that may be reported:

Sometimes that the lab cannot assess the smear to their satisfaction. This happens to about 2% of smears. There are many reasons for this: sometimes there has been some bleeding when the smear was taken which made the smear difficult to read, sometimes too few cells were obtained. It does not mean that there are any abnormalities, just that there were not enough cells to be able to give a result with confidence. A repeat smear is usually taken in the following few weeks.

Borderline smears This means very slight changes were seen in the cells. The changes are not classed as abnormal as they may be due to a particular stage of normal development. Most of the time these changes disappear naturally, and treatment is not required. To check on this, another smear is usually taken after 6 months. If the changes are still present or have developed further, you can be referred for further investigations at the colposcopy clinic.

Infection Sometimes smear tests find an infection. These can be easily treated. If there are no abnormal cell changes then you do not need any extra smear tests, and will be invited for another smear in 3 years time.

Abnormal cells About 5% of smears show some kind of abnormality. These are graded as mild, moderate or severe.

Mild abnormalities frequently resolve naturally without treatment, and this is monitored with another smear taken 6 months later. If the changes are still present or have developed further, you can be referred for further investigations at the colposcopy clinic (link).

More marked abnormalities ( the medical terms are moderate and severe dyskaryosis) are referred to the colposcopy clinic (link) for further investigation as soon as they are found.

Not all these changes will get worse but its not yet possible to tell which changes will get worse and which won’t.

These changes can almost always be treated very easily.

It is important to remember that an abnormal smear is an early warning sign and does not mean that there is a serious problem, such as cancer.

For futher information:
http://www.healthscotland.com/documents/4599.aspx
www.healthscotland.com/documents/4598.aspx
https://www.jostrust.org.uk/about-cervical-cancer/cervical-screening-smear-test-and-abnormal-cells