Ever wish you could ask more questions about cervical screenings or Pap smears, but worried about looking stupid?
The Cervical Screening Program helps save thousands of lives in the UK each year.
But, it’s fair to say that there’s still a bit of mystery about them, and they can be a little embarrassing or scary for some people.
Remember that if you are worried or unsure about anything, it is always perfectly acceptable to seek more information from medical professionals.
In the meantime, for Cervical Screening Awareness Week (June 20-26), we asked experts to answer some of our most pressing questions about Pap smear testing…
Photo of a speculum. Photo credit: Alamy/PA.
1. From what age can screening be stopped?
Zilico clinical specialist Amanda Caley, who works in 15 UK hospitals in colposcopy, says:
“The UK has one of the most robust screening programs in the world, and at 64 you opt for your last annual screening if there are no abnormalities.”
Photo of Amanda Caley – clinical specialist for Zilico. Photo Credit: PA Photo/Amanda Caley.
Professor Jay Chatterjee, consultant gynecologist-oncologist at The Lister Hospital, part of HCA Healthcare UK, notes that “the risk of cervical cancer declines significantly after the age of 65”.
2. How often should I have a Pap smear?
As for routine cervical screenings, Caley explains that the frequency with which they are offered “is not the same across the UK. In England, we start at 25 and until the age of 49, we undergo screening every three years. If there is a problem, you may need to get tested more frequently.
However, in Wales routine screening has been extended to every five years instead of three. In Scotland, it is also every five years.
For people who don’t identify as female but may still need screenings, Caley says: “If you’re not registered as a female with your GP but you have a cervix uterus, call your GP service and ask to be put on the list.
3. Can you book a cervical screening at any time?
“You can’t do it all the time. It has to be your turn, you can’t call 19 and ask for a screening.
“Unless there is a medical reason why you need Pap smears before age 25, they are not routinely done before that age because the risk of cervical cancer is very low.”
However, if you are concerned about unusual symptoms or have a family history of cancer, talk to your GP. They can answer all your questions, provide you with personalized advice and reassure you.
4. How worried should you be if you are called for a biopsy?
First of all, having an abnormal Pap smear result does not mean you have cancer.
Cervical screenings do not actually diagnose cervical cancer. They are designed to prevent the onset of cancer, by checking for certain strains of HPV and cell changes, which may mean you are at higher risk of developing the disease. These can then be monitored or treated, as needed.
If cellular changes are detected during your screening, the next step is usually a colposcopy, which allows a healthcare professional to take a closer look at your cervix. If necessary, a small sample of cells (biopsy) may be taken for further testing.
“A colposcopy will take place in a hospital setting, but the nurses will do their best to make you feel comfortable. There you will be assessed, answer a few questions and sit in a chair with stirrups – yes, like Rachel in Friends,” says Caley.
“There will be some dyes used to change the color of the cells to see if everything is normal. If all of these things indicate that you need a biopsy, then you [have one].”
5. What should you wear for a pap smear?
You can wear whatever you want, but for practicality and comfort, Caley says, “Don’t wear a big jumper or jumpsuit. You look fabulous but you’ll end up sitting in your bra. Wear a nice long dress or sweatpants. Make it easy to get on and off.
6. How many tests do you do per day?
It depends on the clinic, but Caley says:
“As part of primary care in a GP practice, the nurse will treat up to 10 people in the morning in a Pap smear clinic, but this varies.”
7. Is there bodily judgment?
Caley is adamant on this one. “Nope!” she assures.
“We saw it all and couldn’t pick you out of a crowd afterwards. Clinics tend to be more female-run, which may make you feel more comfortable. We’re just here to take a look at your cervix.
8. Is it easier to do cervical screening after childbirth or menopause?
“No, it’s just different. In fact, there are five different types of speculums you can use and you will be graded based on what makes you feel comfortable. We can use a very small speculum if that makes you more comfortable,” says Caley.
“It is advisable to wait at least three months after childbirth before booking a pap smear. In postmenopausal women, the use of vaginal estrogen may facilitate obtaining an adequate smear.
9. Will it be uncomfortable afterwards?
“That’s not normally the case, but everyone is different,” says Caley. Although many people don’t feel any physical discomfort after a Pap smear, some people may experience it – and you can let your nurse or doctor know if you are anxious.
“If you tense up, it will be more uncomfortable. Take a paracetamol beforehand if you are really worried. Take a deep breath and exhale as the speculum comes out,” Caley shares.
10. Should I wax or shave first?
“If you want it, yes, if you usually want it, but you don’t need it for your screening,” says Caley.
“It makes no difference to us whether you are hairy or hairless.”
11. Can I have my screening if I have my period?
“Not really,” Caley said.
“The cells in the lining of your uterus are sloughing off and these cells are not wanted. Call and ask ahead.