A-Z

Cervical Screening

Reasons for attending

In England, Northern Ireland and Wales all women between the ages of 25 and 64 are eligible for a free cervical screening test every three or five years, depending on their age. Women living in Scotland between the ages of 20 and 60 are invited for a test every three years although this is due to change in 2016 to between the ages of 25 and 64 in line with the rest of the country.

 “In the light of evidence published in 20031* the NHS Cervical Screening Programme in England now offers screening at different intervals depending on age. This means that women are provided with a more targeted and effective screening programme.

The intervals are:
 
Age group (years)
Frequency of screening
25
First invitation
25 - 49
3 yearly
50 - 64
5 yearly
65+
Only screen those who have not been screened since age 50 or have had recent abnormal tests”

- from NHS Cervical Screening Programme - About cervical screening.
 
 
“Why are women under 25 not invited?"
Cervical cancer is very rare in women under 25 (64 cases per 100,000 women 2*) but cervical abnormalities linked to HPV infection are very common in women under 25. In most cases abnormalities in young women go away by themselves and do not need any treatment (see our section on 'HPV' for more information). If those under 25 were screened many would test positive for abnormalities and would be sent for unnecessary treatment to remove the affected cells. This treatment may increase the risk of a woman having a pre-term delivery (giving birth before 37 weeks) if she goes on to have children and the whole process can cause lots of anxiety and worry. So it is thought that it does more harm than good to screen women under the age of 25. If a woman under 25 has symptoms such as bleeding after sex or unusual bleeding (not during her period) she should see her GP for advice and this should be investigated (see NHS Clinical Practice Guidance for the Assessment of Young Women aged 20-24 with Abnormal Vaginal Bleeding)

The NHS Cervical Screening Programme routinely invites women who are registered with a GP. Women who have not had a recent test may be offered one when they attend their GP or family planning clinic on another matter.

In our interviews we asked women why they go for a cervical screening test. 

Many women said they have a regular test to enable any changes in their cervix to be detected early and treated before they became more serious. Reassurance that they are well and their cervix is healthy gives them peace of mind.

 

She has regular cervical screening tests so that any changes are detected early.

She has regular cervical screening tests so that any changes are detected early.

Age at interview: 34
Sex: Female
Age at diagnosis: 34
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Well I did know about the procedures of smears beforehand so I knew what I was expecting and again it's part of the fact that instead of looking upon it in a way where it's embarrassing it's much more sensible to be looking upon it in a way that it's a job that, it's something that really should be done that has to be done to prevent any further problems that is possible and I just knew that I was doing the right thing. And I didn't want any further problems to occur so I know that doctors can't prevent these things but they can try and cure if it's, if whatever there is is caught early enough. So I must admit I'm very, I do make sure that I'm up to date with my smears.

 

She believes it would be much worse to find out you have cervical cancer and to know that you...

She believes it would be much worse to find out you have cervical cancer and to know that you...

Age at interview: 52
Sex: Female
Age at diagnosis: 46
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Although I'm quite squeamish I have to say I really don't find that a bad procedure at all. It seems to me to be extremely quick, totally painless. You can feel somebody doing it but it can't even come into the category for me of discomfort. I am quite a squeamish person so why I don't mind that I don't know. I mean I wouldn't choose to go and have a smear if you offered me one now, it's not something you want to have done but it seems to me it's such a quick and painless procedure. Perhaps I am intolerant but I do find it quite difficult to understand why particularly women in relationships or married would find that a difficult thing to have done. I can understand perhaps why a young girl, or somebody that hasn't, who is still a virgin might have a difficulty with that but to me it's not even as bad as giving blood. I don't particularly like having needles stuck in me but I'll do that if I think that it's going to prevent some horrible condition from developing. So perhaps that's, I would spread the word and I do, I sort of say "well it's such a nothing thing have it done because to have cancer must be so awful and to know that you could've done something to avoid it".

 

Tina goes for screening because it’s a two minute procedure to know that she is healthy.

Tina goes for screening because it’s a two minute procedure to know that she is healthy.

Age at interview: 41
Sex: Female
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I’d like to know if I’m getting anything, you know, if anything’s sort of growing there that shouldn’t be really. Obviously it’s for, cancer of the cervix is one of the areas. So obviously that’s, I believe it’s quite a silent cancer. So it’s one that’s not picked up really until it’s quite aggressive, unless you are being screened regularly. So for the sake of going to the doctor, spending about half an hour to get there and to get back, waiting in the waiting room for a two-minute procedure that’s completely painless and no problem, I mean why shouldn’t you go for it?
 

Several women considered cervical screening to be a painless and short procedure with many important benefits. A few compared cervical screening to going to the dentist on a regular basis; both were considered to be important aspects of preventative health care. Others believed they had a responsibility to themselves to take up the opportunity of screening and to keep themselves healthy.

Women who went regularly for cervical screening believed it is too important for women to be put off by embarrassment or discomfort.

 

Regular cervical screening is important in preventing cervical cancer.

Regular cervical screening is important in preventing cervical cancer.

Age at interview: 52
Sex: Female
Age at diagnosis: 37
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A lady who lives across the road she actually died of cancer which could've been prevented and I think that any woman that doesn't go and have a smear check every 3 years is insane. Because okay nobody likes being with their knickers off and nobody likes that but it is so important that it's worth 5 minutes of that horrible feeling of exposure just to know that you're clear.

 

Cervical screening is an important part of looking after yourself.

Cervical screening is an important part of looking after yourself.

Age at interview: 48
Sex: Female
Age at diagnosis: 48
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I think it's essential that women look after themselves and we must do whatever we can. We, most of us wouldn't think twice about going to the dentist twice a year to look after our teeth and is that because it's a visible thing? We have our eyes tested because we need to see to get by and to drive a car but I think you know those hidden things need just as much care and certainly they are more life threatening if they go wrong. I just think it's our duty to look after ourselves, you only get one chance.

Others felt an obligation to attend for cervical screening. Some of these women were influenced by pressure or advice from family and friends. A few said they felt guilty if they did not attend for cervical screening.

 

She put off having cervical screening until she was forty because she was too scared to go for a test. But...

She put off having cervical screening until she was forty because she was too scared to go for a test. But...

Age at interview: 54
Sex: Female
Age at diagnosis: 54
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I was 40 before I had my first smear, didn't want one, didn't want to go through it, that was something other women did and I sort of buried my head in the sand really I suppose. Then I had a bit of a problem, I can't remember what it was now and I told a friend of mine and she said "you've got to have a smear done", and I said "no I'm not going to have a smear". And in the end she made an appointment for me and I went to the GP for my first smear and it was fine. And again it didn't hurt you know what I thought it was going to.

Some women undergo regular cervical screening tests for reassurance that they are well and their cervix is healthy.

 

It’s important to go for cervical screening so that if any changes are found, they can be caught...

It’s important to go for cervical screening so that if any changes are found, they can be caught...

Age at interview: 43
Sex: Female
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Why do you go for screening?
 
Because I’m hoping that if they do find something wrong, it’s better to be caught earlier than, sooner rather than later. And the sooner you find out something’s wrong, the sooner you can have some treatment to hopefully eradicate it. That’s why.
 
So that embarrassment or that awkwardness, that doesn’t put you off?
 
No, it doesn’t. I think in my experience it’s not painful, I’m not particularly embarrassed, and it’s just one of those things that you want to get it done to make sure everything is all right. It’s not something you can see that might be wrong from the outside. So you do need to have it done, yes.
 
 

A few attended regularly for cervical screening because they believed they might be vulnerable to cervical changes because a relative had had cervical problems. There is no medical evidence that abnormal cervical cells or cervical cancer is hereditary.

HPV is a very common infection of the cervix and medical evidence suggests that some types of HPV, which is a sexually transmitted virus, are a major risk factor for cervical cancer. HPV is thought to cause 99.7% of cervical cancers 3*.

For more information see ‘Human papilloma virus (HPV)’ in our ‘Cervical abnormalities: CIN3 and CGIN section or ‘Ideas about causes of cervical cancer’ in our ‘Cervical cancer’ section. 
 

1* P Sasieni, J Adams and J Cuzick, Benefits of cervical screening at different ages: evidence from the UK audit of screening histories, British Journal of Cancer, July 2003

2* Cancer Research UK. Cervical cancer incidence statistics. Accessed: October 2015.

3* Walboomers JMM et al. (1999) Human papilloma virus is a necessary cause of invasive cancer worldwide. Journal of Pathology, 189 (1), 12–19.

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Last reviewed October 2015.

Last updated October 2015.

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