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Cervical Screening Frequently Asked Questions (FAQ)
Cervical screening (smear test) is a quick test to check your cervix (neck of the womb) for the Human Papilloma Virus (HPV).
HPV is a common virus that can cause many different types of cancer. HPV causes 99% of all cervical cancers. Your sample is checked for HPV that can cause cell changes.
NHS cervical screening helps prevent cervical cancer. It stops about one woman getting cervical cancer for every 100 women who have screening.
It saves as many as 5000 lives from cervical cancer each year in the UK. The NHS offers cervical screening to all women aged 25 to 49 years every 3 years and to all women aged 50 to 64 every 5 years. This is because most cervical cancers develop in women aged 25 to 64.
Cervical cancer happens when cells in the cervix grow in an uncontrolled way and build up to form a lump (also called a tumour).
As the tumour grows, cells can eventually spread to other parts of the body and become life-threatening. Your cervix is the lowest part of your uterus (or womb) and is found at the top of your vagina.
Nearly all cervical cancers are caused by cancer causing strains of a virus called High Risk Human Papillomavirus (or hrHPV for short). HPV is a very common virus and most people will be infected with it at some point in their life. It is a virus that is passed on through skin-to-skin contact particularly through any type of sexual activity with a man or a woman.
There are many different types of HPV but only some of them can lead to cancer. The types of HPV which cause cervical cancer can infect your cervix without causing any symptoms at all. In most cases, your immune system can get rid of the virus without you ever knowing you had it. But sometimes, HPV infections can cause cells in your cervix to become abnormal. Usually, your body can get rid of the abnormal cells and your cervix returns to normal. But sometimes this does not happen and the abnormal cells can go on to develop into cancer.
Looking for HPV as the first test on screening samples is currently being introduced into the NHS Cervical Screening Programme. You may hear it being called ‘HPV primary screening’. It helps us to more quickly identify who may need treatment and who can simply be called back for screening in 3 or 5 years’ time.
Once your cervical screening sample is sent to the laboratory, it will first be tested for hrHPV. If hrHPV is found, your sample will also be looked at for abnormal cells. If you don’t have hrHPV, then it is extremely unlikely that you will have any abnormal cervical cells. Testing for HPV first should benefit women because: • More abnormal cervical cells will be picked up • Women without HPV can be reassured that they are at extremely low risk of developing cervical cancer (although we cannot say ‘no risk’) • The information we are gathering during the introduction of HPV primary screening will help us improve the screening programme
- Not be HPV tested
- Be HPV tested only after the sample has been checked for abnormal cells (cytology)
For information about what to expect on the Cervical Screen, please take a look at the online leaflet on patient uk.
There are 3 main types of result from HPV primary screening:
1. No HPV found (hrHPV negative)
If no HPV is found then no further tests will be done. If you don’t have HPV, it is highly unlikely that you will have any abnormal cervical cells. Even if you did, it would be extremely unlikely that they would cause a problem. You will simply be called back for screening again in 3 – 5 years’ time (depending on your age).
2. HPV found (HPV positive) but no abnormal cervical cells found.
If HPV is found, the sample will also be tested for abnormal cervical cells. If none are found, your result will say you have HPV but no abnormal cells. You will be asked to come for screening again in 12 months’ time. This is so we can check that your immune system has cleared the HPV (this happens in most cases). If it hasn’t cleared, you may be at greater risk of developing abnormal cells. If the HPV infection continues you will be referred for colposcopy.
3. HPV found (HPV positive) and abnormal cervical cells found.
There are several grades of abnormal cells. Your result letter will explain what your results mean. If you have HPV and any grade of abnormal cervical cells you will be referred for colposcopy. Colposcopy is a closer examination of the cervix. It is carried out in a similar way to cervical screening. If you are invited for colposcopy, you will be sent an appointment letter to attend this clinic.
It is also possible to have an ‘inadequate’ result. This may be due to a technical problem, such as if the laboratory cannot get an HPV test result from your sample or cannot see if abnormal cells are present or not.
No, there isn’t a treatment to get rid of the virus. For most women, their immune system will get rid of HPV – like getting rid of a common cold. But we can treat abnormal cervical cells, especially if they are found early on. Early treatment means that cervical cancer can be prevented.