Normal and inadequate cervical screening test results

Women who receive a ‘normal’ screening test result, which means that cells in the cervix are normal (typically 19 out of every 20 women screened (NHS Choices 2015)) are asked to return for another cervical screening test in 3–5 years, depending on their age.

Occasionally women can receive an ‘inadequate’ test result. An inadequate test result means that the test must be done again because the laboratory was not able to see the cells properly to give a result. The number of inadequate test results has reduced since liquid based cytology (a way of preparing cervical samples for examination in the laboratory) has been introduced. In England in 2012–13, 2.3% of tests were inadequate and had to be taken again (Cervical Screening Programme, England: 2012–13: Report) most of these are due to not enough cervical cells being taken to give an accurate assessment, or there may have been an infection (such as thrush) or mucous or blood which may be covering the sample taken from the cervix.

We talked to women about how they felt about getting an inadequate test result. Some women said the repeat test was an inconvenience rather than a worry, which they wanted to get over with, especially if they found the test difficult or embarrassing. Others were anxious because they were given insufficient information about why they were asked to have a repeat test and they thought that something was wrong with their cervix. A few felt reassured that their experience was not unusual, once they had spoken to family or friends who had also been asked to have a repeat test.

The nurse explained that her inadequate cervical screening test result meant that they had not taken enough…

Age at interview 27

Gender Female

Age at diagnosis 20

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When it happened before, it’s happened a few times, not majorly but a few times the nurse has always, when I’ve got back the nurse has always explained that basically it’s not, it’s nothing to worry about it’s just she hasn’t managed to get enough of the cells for them to be able to get a decent screening. So it’s just a bit inconvenient really that’s all, it’s nothing that I think “oh no” or worry about, I know that basically she just, they just haven’t got enough to be able to do a proper screening so of course you have to go back and do it again, it’s just normally inconvenient I think “oh no”. It’s not something I really want to go and do again, I’ve already done it once. So yeah I mean it’s never ever been anything that I’ve worried about or panicked about it’s , I think it’s quite clear from the letter they write and then from the explanation itself that it’s , theres just not enough there for them to be able to tell.

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Describes her feelings about receiving her first inadequate cervical screening test result.

Age at interview 62

Gender Female

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It hurt like hell and then the surgery said “Oh theres something wrong here,” and I nearly went bananas and it was simply that they hadn’t got enough testing which years ago we just weren’t told, we were all in the dark. And I thought right okay I’m not going for one of those again. It was when I came out here and then this routine letter, and 12 years and my present place of work were horrified and from then on it’s been no problem.

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Women who have an inadequate test result are normally asked to have a repeat test three months later as this allows the lining (epithelium) of the cervix to regenerate so there are enough cells to test.

Before liquid-based cytology was introduced, some older postmenopausal women had received several inadequate results. One woman needed to have 3 tests before sufficient cells were taken for the test. Another had difficulty getting cells taken during her tests following her treatment for abnormal cervical cells. However these women considered it important to put up with any discomfort and have these re-tests for reassurance that their cervix was healthy.

She has had several inadequate cervical screening test results over the years.

Age at interview 42

Gender Female

Age at diagnosis 25

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Slightly frustrated because I don’t think anyone likes going and having a smear done, it’s not the most dignified of things but obviously you’d go because, especially sort of in light of the history it’s something you accept. But after the third attempt I was thinking oh no, its sort of, and every time they do it they sort of tend to be a little bit more thorough so use a brush and the spatula and it is uncomfortable. And afterwards you feel quite a bit of discomfort. So when, the second time that happened and I was thinking “oh here we go again”, sort of several attempts.

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It’s worth having several repeat cervical screening to know that you are healthy.

Age at interview 62

Gender Female

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Well I didn’t mind because I knew that the nurse had said to me “I’m a little bit doubtful that I haven’t got enough here to be tested,” so I didn’t really, I didn’t mind. The second time it wasn’t so good, the third time it was, it was uncomfortable and it was just sore for a few minutes but she is tremendously experienced and it’s just a bit uncomfortable for a little while. But it’s worth it in the end to find out you’re perfectly alright. I’d rather, I mean I suppose I couldve left it and said no wait but I wanted to make absolutely sure everything was alright, sort of taking her word and everything and that was it. So I had no qualms about that, I’d much rather have gone for 3 or 4 knowing that it was probably going to be alright than to leave any shadow of doubt.

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Receiving cervical screening test results

Cervical screening test results are normally sent to women in writing between 2–6 weeks after the test. However, methods of receiving results and timing vary...