What is the Pap Smear Test​

Cervical screening is responsible for thousands of lives saved each year in the UK. The smear test (now more widely known as cervical screening) is used to detect any cell changes before they can become more serious. If you've received your invitation letter or have any questions about the procedure, we explain everything you need to know below.

Understanding Cervical Screening

Cervical screening tests the health of your cervix, which is the lower part of your uterus. The test looks for human papillomavirus (HPV), the virus that causes more than 99% of cervical cancers. If detected early, abnormal cell changes can be treated to prevent cervical cancer from developing.

Today’s screening process is different from a few years ago. In the past, the test analyzed cells first. Now, the test looks for high-risk types of HPV first. If HPV is present, lab specialists take a closer look at the cells with cytology testing.

Who Needs a Pap Smear Test

All women and people with a cervix between ages 25 and 64 should attend regular cervical screening. You'll receive an invitation letter when it's time to book your appointment.

Here's the screening schedule:

• Ages 25 to 49: Every five years (if HPV negative)

• Ages 50 to 64: Every five years

Trans men and non-binary individuals with a cervix remain eligible for screening. How you receive invitations depends on your registered sex at your GP surgery. If you're registered as male, speak with your GP surgery about receiving automatic invitations.

You may need more frequent screening if you:

• Had abnormal results previously

• Have a weakened immune system

• Were diagnosed with cervical cancer

• Have HIV

At myGynaePlus, our team provides comprehensive women's health services, including cervical screening appointments in a comfortable, supportive environment.

The Procedure: What Happens During Cervical Screening

The test will usually take about 10 minutes. You will lie on an examination table with your feet in stirrups. A speculum, a small plastic or metal instrument, is gently inserted into the vagina. This allows your provider to see the cervix clearly.

Next, a small brush collects cell samples from the surface of the cervix and the area around it. The cells are placed in a vial of liquid instead of being smeared on a slide. This liquid-based method provides clearer results and allows for both HPV and cytology testing from the same sample.

Most people feel some discomfort but not pain during the procedure. If you do experience pain, notify your healthcare provider right away. They can try a different technique or even stop the procedure.

Preparing for Your Appointment

Follow these steps for accurate results:

• Avoid intercourse for two days before the test

• Don't use vaginal medicines or spermicidal products

• Skip douching before your appointment

• Try to schedule when you're not menstruating

If you had sex before remembering these guidelines, attend your appointment anyway. Inform your provider about the timing.

Understanding Your Results

Most results come back within two weeks. Here's what different outcomes mean:

• HPV Negative

No high-risk HPV was found. You'll be invited back in five years for your next screening. This represents the best possible outcome.

• HPV Positive, No Cell Changes

HPV was detected, but cytology showed no abnormal cells. Your immune system will likely clear the virus naturally. You'll receive another test in 12 months to check if the virus has gone.

• HPV Positive with Abnormal Cells

You'll be referred for colposcopy for a closer examination of your cervix. The colposcopist uses a specialised microscope to identify the location and severity of cell changes.

What is Colposcopy

Colposcopy is a closer look at your cervix. A colposcope is a microscope-like instrument that remains outside your body, about 30cm from your vagina. Your provider applies different solutions to your cervix. They highlight abnormal cells by making them change colour.

If there are abnormal cells, a small tissue sample (biopsy) may be removed for testing. The sample is only a few millimetres across. The laboratory result tells you whether you need treatment.

Results are categorised as:

• CIN 1 (Low-grade): Abnormal cells affect one-third of the cervical surface thickness. These often disappear without treatment.

• CIN 2 and CIN 3 (High-grade): Abnormal cells affect two-thirds or the full thickness. Treatment is typically recommended to reduce cancer risk.

  
  

Treatment Options for Abnormal Cells

If high-grade changes are confirmed, then these are usually treated by removal. The most common treatment is called LLETZ or Large Loop Excision of the Transformation Zone. It is also known as loop diathermy. 

The LLETZ procedure involves using a heated wire loop to cut and remove the abnormal cells while conserving as much healthy cervical tissue as possible. It is usually carried out under local anaesthetic as an outpatient procedure. You'll be awake for the procedure, but won't feel any pain.

Following treatment, you will be asked to return for a repeat screening test six months later. This "test of cure" is to ensure that the treatment has been successful. Around 80% of women have a normal result following treatment.

We at myGynaePlus have a team of London's best gynaecologists to provide you with the very best in gynaecology services. We know that receiving an abnormal test result can be a worrying experience, and that is why we will be there for you every step of the way.

Cervical Screening Changes in the UK

Changes have recently been made to cervical screening programmes as a result of medical advances. In July 2025, the NHS announced that women aged 25 to 49 would be screened every five years instead of three. Scotland and Wales had made similar changes to their programmes in 2020 and 2022 respectively.

Extending the screening interval became possible because HPV testing was found to be more reliable than the old cytology-only method. Studies have found that people who are HPV-negative have a very low risk of cervical cancer for several years.

Why Screening Matters

Cervical screening is estimated to prevent 4,500 deaths in the UK every year. The programme detects cell changes years before cancer could develop. Treatment of these cell changes prevent cancer from developing.

Around one in three women don’t attend their screening appointments. This means the programme prevents fewer cancers than it could. Common reasons include embarrassment, fear of discomfort or just forgetting to book.

If you have put off having cervical screening, speak to your GP practice or a sexual health clinic. You don’t need to wait for an invitation letter if you’re overdue for your last appointment.

Self-Collection: The Future of Screening

HPV tests where women self-collect samples have now been approved by the FDA. Self-collection would mean that women use a swab to take a sample of cells from their vagina. 

Self-sampling is not routinely available across the NHS but could become more common in future. In the UK, self-sampling is being assessed as part of service evaluation. Self-collection may help women who have difficulty with clinical examinations or other barriers to attending appointments.

Common Concerns Addressed

1. Does screening hurt? 

Most people describe the sensation as uncomfortable rather than painful. The speculum insertion and cell collection cause brief pressure. Speak up if you feel pain during the procedure.

2. What if I'm pregnant? 

You can have cervical screening while pregnant, though it's usually postponed until after delivery unless there are concerns. If abnormal cells are found during pregnancy, treatment typically waits until after birth.

3. Can I attend if I've never been sexually active? 

Yes. Screening is recommended for all women aged 25 to 64 regardless of sexual history. HPV spreads through skin-to-skin contact, not only through intercourse.

4. What if I've had the HPV vaccine? 

You still need regular screening. The vaccine protects against several high-risk HPV types but not all of them. Cervical cancer can develop from HPV types not covered by the vaccine.

Taking Control of Your Cervical Health

Regular screening is the best defence against cervical cancer. Make your appointment when you are invited. If you are overdue or have any questions in between appointments, do get in touch.

At myGynaePlus we provide all your women's health care needs in one place and a comfortable and confidential setting. Our experienced team provides cervical screening, colposcopy and treatment options.

Please don't let uncertainty or embarrassment stop you from taking this simple step to protect your health. Cervical screening is one of the most effective cancer prevention programmes. Having this simple test every five years could save your life.

FAQs About the Pap Smear Test

Q: How often should I have a Pap smear test?

Women aged 25 to 64 should have cervical screening every five years if their HPV test is negative. The screening interval changed in July 2025 to reflect improvements in testing accuracy. Previously, women aged 25 to 49 were screened every three years. If you have risk factors like HIV or previous abnormal results, your healthcare provider may recommend more frequent screening.

Q: Can I have cervical screening during my period?

While you can attend your appointment during menstruation, it's best to reschedule when possible. Blood can affect the accuracy of test results, making it harder for laboratory specialists to analyse your sample properly. If you start your period before your appointment, contact the clinic to discuss rescheduling. Most providers prefer to test when you're not bleeding.

Q: What's the difference between a Pap test and an HPV test?

A Pap test examines cervical cells under a microscope to check for abnormalities. An HPV test looks for the virus that causes most cervical cancers. Current UK cervical screening uses HPV testing first, then examines cells only if HPV is found. This approach proves more accurate at identifying women who need further investigation. The same sample collected during your appointment can be used for both tests.

Q: Why don't women under 25 get screened?

Cervical cell changes are common in younger women but usually resolve naturally without treatment. Screening women under 25 could lead to unnecessary treatments for cell changes that would disappear on their own. Research shows cervical cancer is extremely rare in this age group. The screening programme starts at 25 because this provides the best balance between preventing cancer and avoiding overtreatment.

Q: What should I do if I receive an abnormal result?

Try not to worry. Abnormal results are common, affecting about one in 20 screening tests. An abnormal result doesn't mean you have cancer. It indicates cell changes that need monitoring or treatment to prevent cancer developing. Follow the advice in your results letter, which typically involves attending a colposcopy appointment. Your healthcare provider will explain your specific results and discuss any treatment you might need. Early detection and treatment of abnormal cells prevents cervical cancer from forming.