Cervical screening helps prevent cervical cancer by finding changes in the cervix(the neck of your womb) before they become serious.
It is not a test for cancer. Instead, it checks for high-risk types of human papillomavirus, commonly called HPV. These types of HPV can sometimes cause abnormal cell changes in the cervix.
Most HPV infections clear naturally and do not lead to cancer. However, if high-risk HPV stays in the body for a long time, it may cause changes that need monitoring or treatment.
What is HPV?
HPV is a very common virus that is passed through close skin-to-skin sexual contact.
Most people will have HPV at some point in their lives without knowing it. It usually causes no symptoms and often disappears without treatment.
Having HPV does not mean that you have cancer. It also does not necessarily mean that you or your partner have recently had another sexual partner, because HPV can remain in the body for many years.
What happens during cervical screening?
During cervical screening, a doctor or nurse gently inserts a speculum into the vagina so they can see the cervix.
A small soft brush is then used to collect a sample of cells from the cervix. The sample is sent to a laboratory and tested for high-risk HPV.
The test usually takes only a few minutes.
What do the NHS screening results mean?
HPV is not found
This means your risk of developing cervical cancer is very low.
In England, you will usually be invited for screening again in five years.
HPV is found, but there are no abnormal cells
This does not mean that you have cancer.
You will usually be invited for another test in 12 months to check whether the infection has cleared.
If HPV is still present, you may need further repeat testing. If it remains present over time, you may be referred for a closer examination of the cervix.
HPV and abnormal cells are found
You will usually be referred for a test called a colposcopy.
A colposcopy allows a specialist to examine the cervix more closely. A small biopsy may sometimes be taken.
The sample could not be tested
Occasionally, the laboratory may not be able to get a clear result. You will usually be asked to repeat the test after about three months.
Who is invited for cervical screening in the NHS?
In England, cervical screening is routinely offered to people with a cervix from age 25 to 64.
You may still have a cervix if you:
- are a woman
- are a trans man
- are non-binary
- have had some types of hysterectomy
People aged 65 or over may still need screening if they have had a recent abnormal result or have not been screened regularly.
Screening programmes may differ slightly in Scotland, Wales and Northern Ireland.
What does the World Health Organization recommend?
The World Health Organization, also called WHO, recommends HPV testing as the preferred method of cervical screening.
WHO guidance is designed for countries with very different healthcare systems.
In countries where women can easily return for follow-up appointments, HPV-positive women may have further tests before treatment.
In places where access to healthcare is limited and many women may not be able to return, treatment may sometimes be offered sooner. This is known as a screen-and-treat approach.
The aim is to prevent women with important cervical changes from being lost to follow-up.
Why are WHO and NHS recommendations different?
The NHS has an organised system for inviting women, repeating tests and arranging colposcopy when needed.
Because women can usually be followed up, the NHS does not normally treat someone simply because HPV has been found.
WHO guidance must also work in countries where women may live far from healthcare services or may not be able to return for several appointments. In these situations, offering assessment and treatment during fewer visits may prevent more cases of cervical cancer.
Both approaches have the same goal: to find and treat important cervical changes before they develop into cancer.
What if I have HIV?
Women living with HIV have a higher chance of persistent HPV infection.
They may need cervical screening more often. In England, annual screening may be recommended.
Your HIV or sexual health team can advise you about how often you should be screened.
Do I still need screening after HPV vaccination?
Yes.
The HPV vaccine protects against the HPV types that cause most cervical cancers, but it does not protect against every high-risk HPV type.
Even if you have been vaccinated, you should still attend cervical screening when invited.
Do I need screening after a hysterectomy?
This depends on whether your cervix was removed.
If you had a total hysterectomy and your cervix was removed, you may no longer need routine cervical screening.
If your cervix was left in place, you will usually still need screening.
Your doctor can confirm whether your cervix was removed and whether further tests are needed.
When should I see a doctor?
Cervical screening is for people without symptoms. It should not be used to investigate symptoms.
Speak to a doctor if you have:
- bleeding after sex
- bleeding between periods
- bleeding after the menopause
- unusual or blood-stained vaginal discharge
- ongoing pelvic pain
- pain during sex
These symptoms are often caused by conditions other than cancer, but they should always be checked.
Do not wait for your next cervical screening appointment if you have symptoms.
Key points to remember
Cervical screening can prevent cervical cancer.
A positive HPV result does not mean that you have cancer.
Most HPV infections clear naturally, but persistent HPV may need monitoring.
Remember!
- Attend screening when invited, even if you have had the HPV vaccine.
- Seek medical advice, from your GP/Gynaecologist, if you have unusual bleeding, discharge or pelvic pain, even if your last screening result was normal.