What is a cervical smear test?
Are smear tests guaranteed to stop women getting cancer?
Who
needs cervical smear tests?
How
often should I have a smear?
Where can I have a smear test?
What happens when a smear is taken?
Can I have a smear test if I have my period?
Does it hurt?
How will I get the result?
What about the result?
Borderline smears
What
is a cervical smear test?
The cervical smear test checks to see that the cells that make up the surface
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 20 and 60 who has ever had sex should have regular cervical smears
How often should I have a smear? In Scotland, woman are recommended to have a smear every 3 years, and will usually be reminded with a letter that this is due.
Where can I have a smear test? Smear tests can be taken at Family planning clinics, well woman clinics or at GPs surgeries (where they are usually taken by the practice nurse). You can choose where to go. Your GP will be informed of the result if the smear 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.
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.
How will I get the result? You should be sent a letter giving you the result of your smear. The letter will tell you if there is any action you need to take, or when your next smear is due. 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:
"Unsatisfactory" smears 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 a 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.
