You can choose if you take part in cervical screening. This leaflet aims
to help you decide. Cervical screening used to be called a ‘smear test’.
Why the NHS offers cervical screening
We offer cervical screening to check the health of your cervix
and help prevent cervical cancer. We look for high-risk human
papillomavirus (HPV). This is because it can cause abnormal changes
that may lead to cervical cancer.
Finding and treating any changes early can prevent most cases of
cervical cancer. Cervical cancer mostly affects women and people
who have a cervix under the age of 45, but abnormal changes can
happen at any age.
Cervical screening saves thousands of lives each year in the UK.
Regular cervical screening is important. You’re still at risk of cervical
cancer even if you:
- have had the HPV vaccine
- have only had 1 sexual partner
- haven’t had penetrative sex
- have had the same partner, or have not had sex, for a long time
- are a lesbian or bisexual
- are a trans man or a non-binary person with a cervix
- have had a subtotal (partial) hysterectomy that did not remove
your cervix.
If you’ve had a total hysterectomy, you do not have a womb or cervix.
This means you do not need cervical screening.
Who we invite for cervical screening
We routinely invite women aged 25 to 64 every 5 years. Most cervical
cancers develop between these ages.
Your GP surgery gives us your contact information. Please make sure
they have the correct details, including your: - name
- date of birth
- address
- mobile number
- email address.
Your invitation will give you information about booking cervical
screening. You can book as soon as you’re invited.
Trans men and non-binary people with a cervix are also eligible
for cervical screening. How you’re invited will depend on how your
gender is recorded in your GP patient record: - If you’re listed as female, you’ll receive invitations automatically.
- If not, you can ‘opt in’ to receive routine invitations. You can do
this by contacting a cervical screening provider, such as your GP, a
sexual health clinic or a transgender health clinic.
If you’re unsure, contact your GP. For more information, go to
www.gov.uk/trans-non-binary-screening.
Cervical cancer is a cancer found anywhere in the cervix.
The cervix is the opening to your womb from your vagina. It’s part
of the reproductive system and is sometimes called the neck of the
womb.
Nearly all cervical cancers are caused by an infection with certain
high-risk types of human papillomavirus (HPV).
HPV is the name for a very common group of viruses. Most HPV
viruses are low-risk and do not cause any problems.
HPV viruses spread easily. You can get HPV from any kind of sexual
contact, including: - any skin-to-skin contact of the genital area
- vaginal, anal or oral sex
- sharing sex toys.
You can catch HPV even if you have not had penetrative sex. Most
people get some type of HPV during their lives. It’s nothing to feel
ashamed or embarrassed about.
You can have HPV for many years even if you have not been sexually
active or had a new partner. HPV does not always cause symptoms, so
you may not know if you have it.
Your body will usually get rid of HPV, but if high-risk HPV stays in your
body, it can cause changes to the cells in your cervix. These changes
may become cervical cancer if untreated.
If you do not have a high-risk type of HPV, it’s very unlikely you’ll get
cervical cancer. This includes if you’ve had abnormal cell changes in
your cervix before.
Cervical screening is usually done by a female nurse or doctor. You
can ask for this when you make your appointment, and your GP
surgery or sexual health clinic will make sure a female healthcare
professional is available.
They’ll take a sample of cells from your cervix with a soft brush for
testing at a lab. After this, most people will not need any further tests.
If we find high-risk HPV in your sample, we also check for any
abnormal changes in the cells. This helps to make cervical screening
results more accurate.
If we find changes, you may need a different test called a colposcopy
to look at your cervix more closely. We’ll offer you an appointment to
discuss this if you need it.
At your appointment
The nurse or doctor will explain to you what to expect at each step of
your screening:
- You will have privacy to get undressed from the waist down. You
may want to wear something you can leave on, like a long jumper,
dress or skirt. - You will be given a paper sheet or towel to put over your waist
area during your screening. - You’ll usually lie back with your legs bent, feet together and knees
apart. You can ask to be in a different position, such as on your
side. Sometimes, you may need to change position during the
test. - The nurse or doctor will gently put a smooth, tube-shaped tool
called a speculum into your vagina. They may use a small amount
of lubricant to help reduce any discomfort. You can ask for a
smaller speculum. You can also ask to insert the speculum yourself
at first. - They’ll open the speculum to see your cervix. Using a soft brush,
they’ll take a small sample of cells from your cervix. You may feel
some discomfort. You can try breathing exercises to help you
relax. - They’ll close and remove the speculum and leave you to get
dressed. They can give you tissues to wipe away any lubricant.
The cervical screening test itself should take less than 5 minutes. The
whole appointment should take about 10 minutes.
The nurse or doctor will be trained to support you. You can also
bring someone with you, such as a friend, relative, partner or support
worker. They can be in the room with you during your appointment.
If you need to empty your bladder before your screening, let the
nurse or doctor know. You can ask for adjustments to help you feel
more comfortable and you should say if you feel any pain.
Go to www.nhs.uk/cervical-screening-appointment to watch a video
of a cervical screening. It shows an illustrated view of inside the body,
and explains what happens during the test.
You may need support to attend your cervical screening. When you
book, tell your GP surgery or sexual health clinic if you need any
reasonable adjustments, such as:
- a longer or double appointment
- information in other languages or formats or an interpreter
- a chaperone in the room with you (another trained member of
staff) - an appointment with a trusted doctor or nurse who you already
have a good relationship with.
You should: - book your screening for when you’re not having a period – this
includes the 2 days before or after you bleed - wait until after any treatment for unusual vaginal discharge or a
pelvic infection - let them know if you are or could be pregnant, as you may need
to delay your screening.
Most people should avoid vaginal medicines, lubricants and creams
for 2 days before cervical screening. However, if you think your
appointment may be more difficult because of vaginal dryness, they
may prescribe a vaginal oestrogen cream or pessary before your
screening.
Some people feel understandably anxious about cervical screening.
This may be because of a mental health condition, past traumatic
experiences, sexual abuse or domestic violence. You are in control of
your cervical screening and can ask to stop at any time. You can read
our guidance for people who find it difficult to attend at
www.gov.uk/cervical-screening-support.
Cervical screening results
The nurse or doctor will tell you when you can expect your results.
There are 3 possible results: - HPV negative
- HPV positive, no abnormal cells
- HPV positive and abnormal cells.
Sometimes we cannot get a result from your sample. If this happens,
we’ll invite you for another cervical screening in 3 months. It does not
mean anything is wrong.
HPV negative Most people (around 87 in 100) have this result. It means we did not find high-risk HPV in your sample. Your risk of getting cervical cancer is very low. We do not need to check your sample for abnormal cell changes in your cervix. We’ll usually invite you for screening again in 5 years. Some people may be invited sooner depending on previous test results. Your results letter will confirm this.
10 Your guide to NHS cervical screening - 11 HPV positive, no abnormal cells.Around 9 in 100 people have this result.
It means we found high-risk HPV in your sample, but there were no abnormal cell changes. We’ll invite you for screening again in 1 year. We ask you to come
sooner than usual so we can check if your body has got rid of the high-risk HPV, which happens in most cases. If you still have high-risk HPV but no abnormal cell changes, we’ll
invite you for screening again 1 year later. If you still have high-risk. HPV after 2 years, we’ll invite you for a colposcopy to look at your cervix more closely.
HPV positive and abnormal cells. Around 4 in 100 people have this result. It means we found high-risk HPV in your sample and abnormal changes to the cells of your cervix. Your results letter will explain this in more detail.
We’ll refer you for a colposcopy. It’s like cervical screening, but it’s done in hospital. A specialist nurse or doctor will look at your cervix using a magnifying lens. This is called a colposcope and it stays outside of the body. If needed, they may take a small tissue sample called a biopsy. You can read more at www.nhs.uk/colposcopy.
Most people who have a colposcopy do not have cervical cancer.
Results for every 100 people who have cervical screening
The NHS records your result on a national database. This means we can
compare your regular screening results. We will keep your sample for 10
years.
87 do not need further tests (HPV negative)
9 are invited for screening again in 1 year (HPV positive, no abnormal cells)
4 are referred for a colposcopy (HPV positive and abnormal cells) - Cervical cancer symptoms
- Symptoms of cervical cancer may include:
- vaginal bleeding that’s unusual for you
- bleeding during or after sex, between your periods or after the
menopause (when your periods have stopped for 12 months or
more) - having heavier periods than usual
- changes to your vaginal discharge
- pain during sex
- pain in your lower back, between your hip bones (pelvis), or in
your lower tummy.
These symptoms are very common and can have many causes, but it’s
important to get them checked by a GP. If cancer is the cause, finding
it early means treatment is more likely to be effective.
If you have another condition, like fibroids or endometriosis, see a GP
if your symptoms change, get worse or do not feel normal for you.
Who is more likely to get cervical cancer
Cervical cancer mostly affects women and people with a cervix under
the age of 45, but it can happen at any age.
You may be more likely to get cervical cancer if: - you’re under 45 – cervical cancer is more common in younger
people - you have a weakened immune system, for example if you have
HIV or AIDS - you have given birth to many children or had children at an early
age (under 17 years old) - your mother took the hormonal medicine diethylstilbestrol while
pregnant with you - you’ve had vaginal, vulval, kidney or bladder cancer in the past
- you smoke
- you’ve taken the contraceptive pill for more than 5 years – this
only slightly increases your risk.
Possible risks of cervical screening
No screening test is 100% reliable.
In cervical screening, this is because: - an HPV infection or abnormal cells can sometimes be missed (a
‘false negative’ result) - there is a small chance that a result says abnormal cells are found
when the cervix is normal (a ‘false positive’ result) - there is a small risk of abnormal cells developing and turning into
cancer in between screening tests.
Cervical screening is not a check for other cancers of the reproductive
system, such as ovary, womb, vulval or vaginal cancer. Do not wait to
contact a GP if you have any concerns.
Possible risks of having a colposcopy
Most people will not need a referral for a colposcopy and will not
need to have abnormal cells removed. If you do need cells removed,
there’s a small risk of bleeding and infection. You’ll get more
information to help you decide if you need a colposcopy.
Cervical cancer symptoms
Symptoms of cervical cancer may include:
You can lower your chance of getting cervical cancer by using
condoms, stopping smoking and eating a balanced diet.
You cannot get cervical cancer if you’ve had surgery to remove your
womb and cervix.
Cervical cancer and the HPV vaccine
The HPV vaccine helps protect against the HPV virus, which causes
most cervical cancers.
It’s recommended for children aged 12 to 13 years old and people
at higher risk from HPV. If you were eligible but missed getting
vaccinated when you were 12 or 13, contact your GP surgery. You can
read more at www.nhs.uk/hpv-vaccine.
It’s still important to attend cervical screening appointments, even
if you’ve been vaccinated against HPV. It does not protect you from
all types of HPV, so there’s still a small chance you could get cervical
cancer.
Cervical screening and HPV vaccination give the best protection from
cervical cancer.
Clinical trials
You may be asked if you want to take part in a clinical trial. These
are medical research studies. Any trial you are offered will gather
information about the best types of screening tests or treatments so
we can improve services in the future. You can choose whether to
take part or not.
More information and support
For advice on cervical screening, you can contact your GP surgery or
sexual health clinic.
This information is available in alternative formats, including other
languages. Go to www.gov.uk/cervical-screening-guide. For easy
read, go to www.gov.uk/cervical-screening-easy-guide.
To request another format, you can phone 0300 311 22 33 or
email england.contactus@nhs.net.
You can also:- find more information on cervical screening at
www.nhs.uk/cervical - read our guidance for people who find it difficult to attend at
www.gov.uk/cervical-screening-support - read information for transgender and non-binary people about
NHS screening programmes. Go to
www.gov.uk/trans-non-binary-screening.
The Eve Appeal are a gynaecological cancer charity. They offer free
and confidential advice on cervical screening. You can email nurse@
eveappeal.org.uk or phone 0808 802 0019. Find more information on
cervical screening at www.eveappeal.org.uk.
About this leaflet
We use personal information from your NHS records to invite you for
screening at the right time. NHS England also uses your information
to ensure you receive high quality care and to improve the screening
programmes. Read more about how we use and protect your
information at www.gov.uk/screening-data.
Find out how to opt out of screening at
www.gov.uk/screening-opt-out.
Image credit(s)
Cover image: Shutterstock/Rawpixel.com
First published: June 2019
This version: July 2025
Leaflet reference: CSP14
PN9346447
© NHS England 202