Cervical screening saves thousands of lives each year in the UK.

The NHS offers cervical screening to check the health of your cervix and help prevent cervical cancer. We look for high-risk human papillomavirus (HPV). This is because it can cause abnormal changes that may lead to cervical cancer.

Finding and treating any changes early can prevent most cases of cervical cancer. Cervical cancer mostly affects women and people who have a cervix under the age of 45, but abnormal changes can happen at any age.

Regular cervical screening is important. You’re still at risk of cervical cancer even if you:

• have had the HPV vaccine
• have only had 1 sexual partner
• haven’t had penetrative sex
• have had the same partner, or have not had sex, for a long time
• are a lesbian or bisexual
• are a trans man or a non-binary person with a cervix
• have had a subtotal (partial) hysterectomy that did not remove your cervix

If you’ve had a total hysterectomy, you do not have a womb or cervix. This means you do not need cervical screening.

Who we invite for cervical screening

We routinely invite women aged 25 to 64 every 5 years. Most cervical cancers develop between these ages.

Your invitation will give you information about booking cervical screening. You can book as soon as you’re invited.

Trans men and non-binary people with a cervix are also eligible for cervical screening. How you’re invited will depend on how your gender is recorded in your GP patient record:

• If you’re listed as female, you’ll receive invitations automatically.
• If not, you can “opt in” to receive routine invitations. You can do this by contacting a cervical screening provider, such as your GP, a sexual health clinic or a transgender health clinic.

If you’re unsure, contact your GP. You can find more information at www.gov.uk/trans-non-binary-screening.

How cervical screening works

Cervical screening is usually done by a female nurse or doctor. You can ask for this when you make your appointment, and your GP surgery or sexual health clinic will make sure a female healthcare professional is available.

They’ll take a sample of cells from your cervix with a soft brush for testing at a lab. After this, most people will not need any further tests.

If we find high-risk HPV in your sample, we also check for any abnormal changes in the cells. This helps to make cervical screening results more accurate.

If we find changes, you may need a different test called a colposcopy to look at your cervix more closely. We’ll offer you an appointment to discuss this if you need it.

At your appointment

The nurse or doctor will explain to you what to expect at each step of your screening:

1. You will have privacy to get undressed from the waist down. You may want to wear something you can leave on, like a long jumper, dress or skirt.
2. You will be given a paper sheet or towel to put over your waist area during your screening.
3. You’ll usually lie back with your legs bent, feet together and knees apart. You can ask to be in a different position, such as on your side. Sometimes, you may need to change position during the test.
4. The nurse or doctor will gently put a smooth, tube-shaped tool called a speculum into your vagina. They may use a small amount of lubricant to help reduce any discomfort. You can ask for a smaller speculum. You can also ask to insert the speculum yourself at first.
5. They’ll open the speculum to see your cervix. Using a soft brush, they’ll take a small sample of cells from your cervix. You may feel some discomfort. You can try breathing exercises to help you relax.
6. They’ll close and remove the speculum and leave you to get dressed. They can give you tissues to wipe away any lubricant.

The cervical screening test itself should take less than 5 minutes. The whole appointment should take about 10 minutes.

The nurse or doctor will be trained to support you. You can also bring someone with you, such as a friend, relative, partner or support worker. They can be in the room with you during your appointment.

If you need to empty your bladder before your screening, let the nurse or doctor know. You can ask for adjustments to help you feel more comfortable and you should say if you feel any pain.

For a video of a cervical screening, go to NHS.UK and search for ‘what happens at your cervical screening appointment’. It shows an illustrated view of inside the body, and explains what happens during the test.

Practical hints and support

You may need support to attend your cervical screening. When you book, tell your GP surgery or sexual health clinic if you need any reasonable adjustments, such as:

• a longer or double appointment
• information in other languages or formats or an interpreter
• a chaperone in the room with you (another trained member of staff)
• an appointment with a trusted doctor or nurse who you already have a good relationship with

You should:

• book your screening for when you’re not having a period – this includes the 2 days before or after you bleed
• wait until after any treatment for unusual vaginal discharge or a pelvic infection
• let them know if you are or could be pregnant, as you may need to delay your screening

Most people should avoid vaginal medicines, lubricants and creams for 2 days before cervical screening. However, if you think your appointment may be more difficult because of vaginal dryness, they may prescribe a vaginal oestrogen cream or pessary before your screening.

Some people feel understandably anxious about cervical screening. This may be because of a mental health condition, past traumatic experiences, sexual abuse or domestic violence. You are in control of your cervical screening and can ask to stop at any time. For guidance, go to GOV.UK and search for ‘Cervical screening support for people who find it hard to attend’.

Cervical screening results

The nurse or doctor will tell you when you can expect your results. There are 3 possible results:

• HPV negative
• HPV positive, no abnormal cells
• HPV positive and abnormal cells

Sometimes we cannot get a result from your sample. If this happens, we’ll invite you for another cervical screening in 3 months. It does not mean anything is wrong.

Depending on your results, you may be invited for a screening again in 5 years, in 1 year, or you may be invited for a colposcopy which is like cervical screening, but it’s done in hospital. More information about having a colposcopy is available at www.nhs.uk/conditions/colposcopy.

Most people who have a colposcopy do not have cervical cancer.

This information has been taken from the “Your Guide to Cervical Screening” long-read document. To read the full version or for an audio version of the guide, visit the NHS website.