How to make cervical screening (a smear test) work for you
Cervical cancer is the 14th most common cancer among women in the UK. Although it’s highly preventable through regular cervical screening – which some people refer to as ’going for a smear test’ – the NHS has not reached a target to screen 80 per cent of eligible women, over the past 20 years. Its uptake has been decreasing, with nearly a third of eligible women in England not coming forward for screening in 2023.
New research from Healthwatch England shows that some of the common barriers that stop women from taking up cervical screening are physical discomfort, embarrassment to undress and a belief they don’t need to attend as they aren’t currently sexually active. You can read more about the findings of this research here.
In this blog we answer some of the key questions about cervical screening and the adjustments you can ask for to improve the experience of your screening appointment.
Do I have to attend cervical screening?
Attending a cervical screening appointment is your choice. However, the NHS highly recommends everyone with a cervix attend screenings, as they are vital to prevent cervical cancer.
Knowing what support is available and adjustments you can ask for may make it a more pleasant experience if you are worried about attending.
How is cervical screening done?
According to information on the NHS website, a nurse or doctor will use a soft brush to collect a small sample of cells from your cervix. The sample is checked for human papillomavirus (HPV), which can cause changes to the cells of your cervix. The process is quick; it usually takes about five minutes. Check out this NHS video showing someone having a cervical screening.
Your cervical screening results are usually sent to you in a letter. Your nurse or doctor will tell you when you can expect your results.
What should I consider before booking my cervical screening appointment?
You do not need to do anything special to prepare, but there are things that may help, the NHS website says:
- Book your screening for when you're not having a period – this includes the two days before or after you bleed.
- Wait until after any treatment for unusual vaginal discharge or a pelvic infection.
- Avoid vaginal medicines, lubricants and creams for two days before your appointment.
What cervical screening support is available?
You may feel anxious or worried about attending for several reasons. If you feel concerned about your appointment, you can discuss this with a health professional who can help when booking the appointment. Some adjustments you can ask for include:
- Book the first appointment of the day to avoid waiting in waiting rooms for a long time.
- Ask to be seen by a trusted doctor or female health professional.
- Ask for a chaperone. This is usually another health professional, although you can also bring a friend, relative or carer.
- Ask for a longer appointment if you feel you may need more time during the appointment.
- Ask for an appointment, just to talk about what happens during the screening first.
- Ask for a vaginal oestrogen cream or pessary to be prescribed ahead of your appointment, if you think screening may be more difficult after menopause.
What adjustments can be made during the appointment to make it more comfortable?
There are a number of adjustments you can ask for during your cervical screening. These include:
- If you feel uncomfortable during your screening or are worried about removing your clothes, you can wear a skirt, dress or long top. This may help you to feel more covered, as you can keep these clothes on during your test and will only be asked to take off your underwear. Health professionals will always give you a modesty sheet to cover you.
- You may feel more comfortable in different positions, like lying on your side. Your doctor or nurse will work with you to make sure you’re in the best position for yourself.
- You can also a ask for a smaller speculum. Health professionals will use a speculum to see your cervix. They come in a range of sizes. You can talk to your health professional about which size suits you best.
- It may help to agree on a word or hand signal during the test, so the health professional knows to stop if you need a break or feel uncomfortable.
What are self-testing kits?
A self-testing kit, which detects human papillomavirus (HPV), a group of viruses that can lead to cervical cancer, helps women carry out cervical screening in the privacy and convenience of their own homes. HPV home kits are currently available to buy at pharmacies at costs of between £29 to £129 but they’re currently not available on the NHS.
Earlier this year, a trial led by Kings College London to offer women a self-testing kit concluded it could boost the number of women undergoing cervical screening by 400,000 a year.
Find out more about women’s views on self-testing kits.
Where can I learn more?
Follow the links below for more important on cervical screenings, cervical cancer and support available.
About our campaign
We have launched a campaign to support NHS England’s ambition to eliminate cervical cancer by 2040.
Our report “Cervical screening my way” highlights the importance of professionals who carry out screening, being sensitive to the concerns and past experiences of women, and taking time to answer their questions, allay fears and make practical adjustments during appointments.
