Let’s talk about SMEAR tests with Dr Philippa Kaye

Smear tests are not something we look forward to, and the last year hasn’t made it any easier. Since the onset of COVID-19, a third of us have missed our smear tests for obvious reasons. Cervical screenings are a crucial part of looking after our health and are estimated to save over 4000 lives every year. To mark this year’s Cervical Screening Awareness Week, we caught up with Dr Philippa Kaye, a GP ambassador for Jo’s Cervical Cancer Trust to discuss exactly why these screenings are so important, what’s involved and how often we should be getting them.

1. What exactly is a smear test, and why is being tested so important?

A smear test, otherwise known as a cervical screening is a free health test available on the NHS as part of the national cervical screening programme. It helps prevent cervical cancer by checking for a virus called high-risk HPV and cervical cell changes. It is not a test for cancer.

2. When, and how often, should people go for a cervical screening (smear test)?

You are invited for cervical screening between the ages of 25 to 64. Your cervical screening result will determine when you are next invited for cervical screening. You may be invited every year, every 3 years or every 5 years.

3. Why do so many people skip their smear test?

Cervical screening can be a difficult test for many reasons including embarrassment, fear, an existing health condition (which might cause pain), previous experience of trauma or gaps in understanding about what the test is for. The impact of COVID-19 has provided further confusion and uncertainty about attending.

4. What’s involved in a smear test, and is it painful?

Your nurse will ask you to lie on an examination bed and give you a new, clean paper sheet to cover the lower half of your body. You can lie:

  • On your back with your legs bent up, your ankles together and your knees apart.
  • On your left side with your knees bent.

Your nurse will let you know when the test is about to start and., then will gently insert a new, clean speculum into your vagina. A speculum is usually a plastic cylinder with a round end. Once the speculum is inside your vagina, the nurse will gently open it so they can see your cervix. Then the nurse will use a small, soft brush to quickly take a sample of cells from your cervix. This may feel a bit strange, but should not be painful. The nurse will put your sample of cells into a small plastic container (vial) of liquid. The liquid preserves the cells so they can be sent to a lab for testing.

5. How long does it take?

Coronavirus means that your GP surgery may be doing appointments a bit differently. Your GP surgery wants to keep you and your healthcare team protected from Coronavirus, so they will be following government guidance on social distancing and using appropriate personal protective equipment (PPE). This means your visit might be longer than usual. Plan to spend at least 30 minutes at your GP surgery, which may include waiting for your appointment or being directed to the room. However, sometimes you might find it’s quicker at the moment, as there can be less hanging around! The test itself, where your nurse takes a sample of cells from your cervix, will still only take a few minutes.

6. How would you recommend preparing for a smear for those who are feeling anxious and unsure?

Whether it’s your first time or you have been before, we know that going for cervical screening may make you feel anxious. It may help to remember that everyone has a different experience of cervical screening. If you need any support, it is important to let your nurse or doctor know. There are lots of things you can try to make it a bit easier, including taking music or a podcast with you, booking a double or longer appointment, wearing a skirt or dress, or asking for a smaller speculum.

7. What is Human Papillomavirus (HPV)?

HPV is the name of a common virus. It infects the skin and any moist membrane such as the cervix. HPV is usually passed on through sexual contact, which can make some people feel worried or embarrassed, but it is nothing to be ashamed of. HPV lives on our skin, it is easy to get and difficult to completely protect against - in fact 8 in 10 men and women will get HPV at some point during their lives . In most cases, your immune system will get rid of HPV without it causing any problems. Sometimes it can cause cells to change which is why screening is so important as we can identify this at the earliest stage.

8. Is a smear test the same as an HPV test?

Kind of! When a sample is collected during your smear test, across most of the UK it is tested for HPV because HPV causes almost all cervical cancers. If you don’t have it your chance of developing cervical cancer is really low. As the person having the test, the process is exactly the same.

9. Where is the best place to find out more about smear tests? Could you share some resources?

Jo’s Cervical Cancer Trust is a fantastic resource. If you have questions or concerns about HPV, the HPV vaccine, cervical screening (a smear test) or cervical cancer, their support services can help by providing accurate information and someone to listen. There’s online and face-to-face support as well as opportunities to talk to and meet others in a similar situation.

This includes their free Helpline on 0808 802 8000. Give them a follow on social media too to see what they’re up to and get tips and information that way.

10. If you could share one piece of information and/or advice on cervical screening as a healthcare professional (something you’d want written on a t-shirt for all to see!) what would it be?

Cervical screenings aren’t always easy but they save lives.

Further reading...