I think we can safely say that no one likes going for a smear test. They can be a little awkward, slightly uncomfortable and waiting for any kind of result is a bit nerve-wracking. But they’re nothing to be afraid of – in fact, they can be a life-saving (it’s estimated that if everyone attended screening regularly, 83% of cervical cancer cases could be prevented).
Unfortunately, the results of a recent survey by Public Health England has revealed that cervical screening attendance is at a twenty-year low, with only one in four eligible women not attending their tests – and the pandemic has not helped matters.
Plus, new research and development means that people can safely attend smear tests less frequently, down from one every three years to one every five years, if they are offered a new screening test that tests for the human papillomavirus (HPV), a common virus with over 100 variations, a few of which can lead to cervical cancer (traditional cervical screening involves a cytology test that checks for abnormal cell changes on the cervix as well as the HPV virus).
If no infection is found, a study of 1.3million people who were eligible for smear tests, published in the British Medical Journal, confirms that it’s safe to wait five years before the next routine check. In fact, the study showed that the chance of abnormal cell changes developing in between traditional cytology smear tests was four in 1,000, whereas the new HPV test was only one in 1,000.
While we may be able to wait longer in between checks, it’s still important to attend. “It is very important to have cervical smears done regularly and to follow up previous abnormal results with another smear test as required,” Dr Belinda Griffiths from The Fleet Street Clinic explained. “Failure to do so can result in surgical procedures which are more radical than would be necessary if abnormalities were picked up earlier. If early changes on the cervix are left, a larger area of the cervix has to be removed in order to clear the possibly cancerous changes, which in turn, can lead to subsequent difficulty in pregnancy and a higher risk of miscarriage, than would have been the case if treated earlier.”
To help answer any questions you may have, we’ve called upon Rebecca Shoosmith, head of support services at the UK’s leading cervical screening charity, Jo’s Trust, to set the record straight ahead of yours…
What is a cytology smear test?
A cytology smear test, otherwise known as traditional cervical screening, is a short five to 15 minute test that checks the health of the cervix. It is not a test for cancer – rather, it is a test that helps to prevent cancer.
The test is performed by a qualified nurse or doctor and involves a visual inspection of the cervix as well as collection of a small sample of cells. For the test, you will need to undress from the waist down (although you can cover up with a paper sheet if preferred) and lie back with legs bent, knees down and feet together. The practitioner will slowly insert a small tube known as a speculum into the vagina (don’t worry, they can use lubrication if needed or you can ask for a smaller speculum), which gently opens up to reveal the top of the cervix. Then, a few cells are collected using a soft brush, which are then sent to the labs and tested for abnormalities and human papillomavirus (HPV).
What is the new HPV test?
The new HPV test that will replace traditional cytology cervical testing is a simple swab test that is performed by a doctor or nurse at your GP practice, or in some cases, via an at-home testing kit supplied by the NHS. Once completed, the swab is sent off to the labs for analysis to check for the presence of high risk HPV strains.
Does it hurt?
Everyone’s experience of a smear test is different, with the majority of women reporting no pain or mild discomfort. The new HPV tests are arguably less invasive that the traditional cytology tests, and do not involve the use of an instrument known as a speculum that opens the vagina in order to access the cervix. Instead, the HPV tests involve inserting a small swab (similar to a cotton bud but longer) into the vagina, and rotating it for 20 seconds.