Many people don’t know just how simple smear tests can be. They only take a few minutes, and Public Health England research shows that once women have been screened, 8 in 10 (87%) are ‘glad they went’ and that they were ‘put at ease by the nurse or doctor doing the test’ (84%). Regular screening is important because it can help stop cervical cancer before it starts.
In the UK, cervical screening (commonly known as a smear test) usually starts from the age of 25.
Cervical screening in the UK now uses HPV primary testing. This means that the sample collected during your smear test is first tested for high-risk types of human papillomavirus (HPV) – the virus that can cause changes in the cells of the cervix. If high-risk HPV is not found, you won’t be checked for abnormal cells, and you’ll simply be recalled in the usual screening interval. If high-risk HPV is found, the same sample is then examined for abnormal cell changes.
For those who are unsure, here is a step-by-step guide to what happens during a smear test:
- The equipment required is laid out on a clean tray. This includes a speculum, lubrication, cytobrush and thin prep pot.
- The woman should understand the test she is having and give verbal consent to go ahead.
- She usually gets ready in privacy and removes her lower half clothing.
- She lies on an examination couch with her legs covered with a sheet.
- The clinician places the speculum which is covered in lubrication inside the woman’s vagina and visualises her cervix.
- The cytobrush is applied to the cervix and rotated ten times in a clockwise direction. The speculum is removed from the woman’s vagina and she can get dressed.
- The brush is placed in the thin prep pot and moved around to release cells from the brush into the thin prep solution. The lid is applied to the pot and the pot labelled and sent to the laboratory.
…And here are some things that don’t happen:
- Smear tests are very painful – smear tests may feel a little uncomfortable but should not be painful.
- An abnormal smear test means you have cancer – an abnormal smear is very common and does not mean cancer. It means that your smear test has done its job and picked up an abnormality before it becomes anything serious These pre-cancerous cells can be then diagnosed and treated using colposcopy, so that cervical cancer is prevented.
- They check for sexually transmitted infections – they don’t.
- I don’t think I need a smear test – anyone with a cervix should have regular smear tests.
- You don’t have to go for cervical screening if you have had the HPV vaccine – the vaccine provides a high degree of protection against cervical cancer, however it does not provide full protection. The new vaccine (Gardasil 9) prevents up to 90% and the old vaccine prevents up to 70% of all cervical cancers. Therefore, it is very important that you still attend regular screening even if you have been vaccinated to reduce your risk and have maximum protection.
Written by Miss Meg Wilson, Consultant Gynaecologist.
This blog was last reviewed in June 2025 by:
- Miss Shree Datta, Consultant Obstetrician and Gynaecologist
- Dr Amelia Davison, Consultant Obstetrician and Gynaecologist
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