Disclaimer: We acknowledge that not all women have vaginas and not all people with vaginas identify as women, however, most studies into cervical screenings use the category of ‘women’ to cover those with vaginas.
Smear test, the words send shudders through the hearts of young women. This is a test to help prevent cancer as there are around 3,200 new cervical cancer cases in the UK every year, that’s over 8 every day, making cervical cancer the 14th most common cancer among women. A scary statistic at first glance, right? However, studies show that 99.8% of cervical cancers cases in the UK are preventable.
Figures revealed cervical screening rates amongst all ages were at their lowest for two decades. Almost one in three women aged 25-64 had not had their smear test within the timeframe the NHS recommends, which is every three years for women aged 25 to 49, and every five years for those aged 50 to 64.
Many women put off their smear tests out of fear and underestimate the importance of cervical screenings. Data collected by Jo’s Cervical Cancer Trust found that those aged 25-35 were put off by a stranger examining them with 67% saying they would not feel in control.
As a part of their #SmearForSmear campaign, the trust surveyed over 2,000 young women about their experiences. When asked what had caused them to delay or miss a test, 72% said embarrassment, while 58% were scared it would hurt and 37% did not know what would happen during the test. Of all women surveyed, 68% said they would not tell their nurse about their worries and almost half said they regularly delayed or did not go for tests. Other concerns were the fear of being judged (18%) or thinking their concerns were too silly or small (16%).
With the complications of COVID-19 came a delay in appointments throughout spring and the postponement of dread of receiving your first invitation. Now with the backlog cleared, the NHS is urging women to book their screening and to contact your GP surgery online or by phone if you think you are due to have cervical screening but have not been sent an invitation.
Whether you’re confused when to book your test, unsure of the steps to take before the appointment or what the process entails, Stephanie Taylor, a pelvic health expert at Kegel8, has you covered with a beginner’s guide to calm them overwhelming nerves.
What is a smear test and what does it involve?
A smear test, or cervical screening, is a routine health check offered to women via a letter from the age of 25 – 64. Usually, it is performed by a qualified nurse at either your GP surgery or in a sexual health centre.
The screening collects cells from your cervix, the opening of the womb from your vagina. It tests for human papillomavirus (HPV) that can cause cervical cancer over time. If these types of HPV are not found, you do not need any further tests. However, if these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they have time to turn into cervical cancer.
As frightening as it may sound most women will experience no or only mild discomfort during the test. For those who have had a vaginal exam or had the coil fitted prior, the process isn’t so different.
Why is it important to book your first test?
Essentially, these screenings can be lifesavers. Cervical cancer can take a few years to develop as the abnormal cells form, so smear tests can catch any problems early before they become dangerous.
Around your 25th birthday, you’ll receive an invitation in the post to attend a smear test. Don’t put off your first smear test; it’s one of the best ways to protect yourself against cervical cancer and you’ll be re-invited every three to five years until you’re 64.
If you have had the HPV vaccine, it’s still important you attend your smear tests as this doesn’t protect you from all types of HPV. The vaccine only protects against the 2 types of HPV that cause most cases of cervical cancer, but not all types.
What happens during your appointment?
Once arrived for your smear test the nurse will go through exactly what’s going to happen so you feel relaxed and can ask questions beforehand. You will then be asked to remove your clothes from the waist down behind a screen, before lying on the bed with a sheet over you. Next, they will instruct you to bend your legs with your feet together and knees apart.
Once ready, the nurse will gently put a smooth tube-shaped tool (a speculum) into your vagina – with lubricant – to take a sample of cells from your cervix with a soft brush. This will then be closed and removed. If you find yourself in pain, your nurse can take steps to ease this like asking you to change position or using a smaller speculum.
The appointment usually lasts about 10 minutes with the actual test itself taking only 5 minutes. You should get your cervical screening results by post up to 4 weeks after.
You’ll be told when to expect your results after the test. If the result is positive for HPV cells, there’s no need to panic. The sample will be checked for abnormal changes. If the result is unclear, they may invite you back in three months for a second screening.
Spotting or light bleeding after your screening is very common and nothing to be worried about. This should go away after a few hours and will be painless. You might like to bring a sanitary towel or panty liner with you just in case (some GPs also have these on hand). If the bleeding is very heavy or lasts longer than 24 hours, tell your GP.
Top tips on how to prepare:
1. Mostly, try to relax. The more relaxed you are, the easier and quicker the test will be. Your nurse can talk you through simple breathing techniques to help.
2. If you feel self-conscious about getting undressed, wear something you can leave on during the test like a skirt or long top. But remember, nurses see hundreds of women like this every year and you will not be judged.
3. You’re also able to listen to music or read a book during the test and you can ask someone to attend the appointment with you to calm your nerves.
4. Before your appointment, avoid sex, lubricants and any other artificial substances in your vagina, even medicinal ones. These can make test samples less accurate.
5. Avoid booking a screening around your period as this can make the process harder and cause false negatives. If your period isn’t regular, don’t stress, it’s still possible when mother nature calls.
6. It’s also worth noting you may request a female nurse, just ask when booking your appointment.
As well as going for screening when you are invited, is it vital you continue to look out for any unusual changes to your body. Check for abnormal bleeding (such as bleeding between periods), vaginal discharge that smells unpleasant, and pain during sex. See your doctor if you notice anything unusual. Many conditions can cause these symptoms and most of them are much more common than cervical cancer. However, you should always get your symptoms checked out.
Words by Paul McAuley.
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