Word on Health

Word on the National Cervical Screening Programme

Our grateful thanks to Jo's Cervical Cancer Trust for their contribution to this week's report and for the use of the support information below. The charity provides a helpline 0808 802 8000 or you can email them via this link

Cervical Screening (smear test)

5 million UK women and people with a cervix are invited to cervical screening annually. It is estimated that the UK Cervical Screening Programme saves around 5,000 lives each year.

In England, Wales and Northern Ireland women are invited for screening from the age of 25-64 every 3 to 5 years depending on age. In Scotland they are invited between 20 and 60 every 3 years - this rose to 25-64 on April 1st, 2016.

Its estimated 1 in 5 who are invited for screening don't attend.  Pre-pandemic  research suggest that a third of women had skipped their test and  around three million women across the UK hadn’t had a test for at least three and a half years.

Cervical Screening Tips 

Everyone has a different experience of cervical screening and it is not easy for everyone. If you are worried about the test or know you find it hard, contact the Jo's Cervical Cancer Trust helpline on 0808 802 8000. 

If you are looking for ways to make cervical screening (a smear test) better for you, there are lots of things you can try.  The tips, listed below, provided by the experts at Jo's Cervical Cancer Trust,  are for everyone, although you may feel some are not right for you. 

Talk to your nurse or doctor.  If it is your first cervical screening, you feel embarrassed or worried, you have had a bad experience before, or you have experienced anything that makes the test hard for you, telling the person doing the test means they can try to give you the right support. If you don’t feel comfortable saying something, try writing it down.

Ask for the first appointment of the day.  If you feel uncomfortable in waiting rooms, you may want to ask to book the first appointment of the day. This can mean it is quieter and there is less time for you to wait. 

At the moment, many GP surgeries are not using waiting rooms because of coronavirus. Instead, you may be asked to wait outside until you are called in for your appointment. If your surgery is using a waiting room, it will be much quieter because they are trying to limit the number of people in the surgery.

Ask to book a longer or double appointment.  Having more time before, during or after cervical screening can help people take in information about the test and process everything that happens. If this would be useful for you, you may want to check if your GP surgery can offer you a longer appointment. 

The receptionist may ask why you need a longer appointment – remember, you do not have to disclose anything. 

Ask for a nurse or doctor of a particular gender. You may feel more comfortable knowing that a female or male nurse will be doing your cervical screening. If you have a nurse or doctor you trust, you may want to check with your GP surgery if they are able to do it. 

Take someone you trust with you.  At the moment, GP surgeries may not allow someone else to come into your appointment or the surgery with you. This is because they are limiting the number of people in the surgery, to help protect against coronavirus. 

However, if it would help or you need assistance, it is still worth asking if someone can come with you. It could be a friend, family member, partner or someone else. They can be in the waiting room or examination room with you to offer support. They may also be able to speak on your behalf about any worries. 

If a trusted person isn’t able to come to the appointment, you can check if another member of staff can be with for support. This person is sometimes called a chaperone.

Wear a skirt or dress. If you feel comfortable wearing a skirt or dress, it may help you feel more covered. You can keep it on during the test and only take off your underwear. 

You do get a paper sheet to cover yourself. If you would like to, you can also ask if you can bring a spare shawl or blanket too.

Ask for a smaller speculum. Speculums come in different sizes. If you find the standard size too uncomfortable, you can ask to try another size. 

Put the speculum in yourself. You may feel more relaxed and comfortable about putting the speculum in your vagina yourself. If you have a partner with you, you may prefer them to put the speculum in. 

Lie in a different position. Lying on your back may feel uncomfortable for lots of reasons. You can ask to lie on your left hand side with your knees bent (left lateral position).

Use post-menopausal prescriptions. If you have gone through or are going through the menopause, let your doctor or nurse know. After menopause, the opening of the vagina and vaginal walls become less able to stretch, which can make the test more uncomfortable. You can ask your nurse to give (prescribe) you a vaginal oestrogen cream or pessary, which may help.

Ask to be referred to colposcopy. Sometimes the nurse may not be able to see your cervix. This could be because you have a tilted cervix, cervical stenosis (where the vagina narrows) or something else. It does not mean there is anything to worry about. The nurse may suggest you go to a colposcopy department for cervical screening, as they have equipment like adjustable beds that can help when trying to see the cervix. 

Visit a specialist cervical screening clinic. Some people prefer to go for cervical screening in a clinic that meets their needs. 

If you have experienced sexual violence, the charity My Body Back has clinics in London and Glasgow. The London clinic is for people living anywhere in the UK, and the Glasgow clinic is for people living in Scotland. My Body Back clinics are now open, so please contact them to book your appointment.

If you are a trans man and/or non-binary person with a cervix, you may experience dysphoria around cervical screening, as well as other feelings that make the test difficult. If you want to go for cervical screening, there are a number of specialist clinics in the UK. Due to coronavirus these clinics, except 56 Dean Street in London, are closed for cervical screening, so you may want to wait until they are open for appointments:

About Cervical Cancer

Cervical cancer is the most common cancer in women under 35. Every day in the UK 8 women are diagnosed and 3 women die of cervical cancer. Over 300,000 UK women a year are told they have a cervical abnormality that could require treatment. 

Cervical cancer is often symptomless. However, the most common symptoms are:

  • Abnormal bleeding during or after sexual intercourse or between periods
  • Postmenopausal bleeding
  • Unusual and/or unpleasant vaginal discharge
  • Discomfort or pain during sex
  • Lower back pain

Human Papillomavirus (HPV)

99.7% of cervical cancers are caused by HPV. Around 13 high-risk types of HPV are responsible for causing cervical cancer. The high-risk types 16 and 18 are most prevalent, causing 70% of cervical cancers.

80% of women are infected with genital HPV at some point in their lives, but never know they have been affected because HPV is usually cleared (without treatment) by the body’s immune system.

There are currently two vaccines which protect against HPV infection. These are called Gardasil and Cervarix. The NHS vaccination programme currently uses Gardasil to vaccinate girls aged 12-17. Girls aged 12-13 will be routinely offered the vaccine in school but it is possible to obtain the vaccine via a local GP surgery.

Women who have received the HPV vaccine will still have to attend the cervical screening as the vaccine protects against only 70% of cervical cancer.

Research indicates that the HPV vaccine could prevent two-thirds of cervical cancers in women aged below 30 by 2025 but only if uptake of the HPV vaccination is at 80%. 

HPV Myths

You can’t contract HPV if you use condoms. Wrong!   Practising safe sex through the use of condoms can help reduce the risk of being infected with HPV but it will not completely eradicate the risk as HPV lives on the skin, in and around the whole genital area.

You can’t contract HPV and go on to develop cervical cancer if you have only ever been with one partner. Wrong! Anybody who has ever been sexually active is at risk of contracting HPV. Genital HPV is transmitted primarily by skin-to-skin contact including genital-to-genital contact, anal intercourse and oral sex.

People who have cervical cancer are promiscuous or their partner has cheated on them. Wrong! The time from exposure to the virus, to the development of warts or cervical disease, is highly variable and the virus can remain dormant in some people for long periods of time. Often it is not possible to determine exactly when or from whom the infection originated.

I haven’t had sex for a long time, so now I don’t need to go for my cervical screening. Wrong! The time from exposure to the virus, to the development of warts or cervical disease, is highly variable and the virus can remain dormant in some people for long periods of time.

You can’t contract HPV and go on to develop cervical cancer if you have only ever been sexually active with a woman.Wrong! All women and people with a cervix regardless of their sexual preference who are over the age of invitation should have regular cervical screening. Most cervical abnormalities are caused by persistent infection with HPV. As HPV can be transmitted through skin-to-skin contact in the genital area, gay women are at risk of contracting HPV and experiencing abnormal cervical changes and thus, should always attend when invited for cervical screening.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.