Cervical screening
Cervical screening (previously known as a smear test) is a health check for your cervix. Regular screening is one of the best ways you can protect yourself from cervical cancer.
Cervical screening is for everyone who has a cervix, including trans men and non-binary people.
If you’re LGBTQ+ and have a cervix, you can and should get a cervical screening.
Read our article: Do I need to attend a cervical screening if I’m queer?
In the screening, a small sample of cells is taken from your cervix, at the entrance of the womb. These cells are checked for certain types of human papillomavirus (HPV).
If no HPV is found in your cells, this means your chance of getting cervical cancer is very low. You do not need any further tests. And you should attend your next cervical screening when you’re invited in 3 or 5 years.
If HPV is found in your sample, it gets tested again to check for abnormal cells before you are given a result. You’ll then get a HPV positive result. There are 2 types of HPV positive results:
HPV found but no abnormal cells: you’ll be invited for more regular screenings (in 1 year and 2 years) to check if you still have HPV
HPV found and abnormal cells found: you’ll be asked to go for another test to look at your cervix, called a colposcopy
What is HPV?
Human papillomavirus (HPV) is the name of a group of viruses that live on the skin. HPV is incredibly common. Most people will get it at some point in their lives. And most of the time it does not affect your health.
There are hundreds of types of HPV that are harmless surface infections. Your body can clear these on its own and you’ll never know you had contact with the virus. Another type of HPV causes genital warts.
Some types of HPV are considered high-risk. Some people who get a high-risk type of HPV will not be able to clear it. This can cause abnormal tissue growth and changes that can lead to cancer if they’re left untreated.
HPV is spread via skin to skin contact. This means it can spread during all kinds of sexual activity. Condoms are the best protection against HPV.
When should I get a screening?
All women and people with a cervix should go for regular cervical screenings between the ages of 25 and 64. Outside of this age range, cervical cancer is very rare.
If you had the HPV vaccine at school, you will still need to have a cervical screening.
Cervical screenings are free. In England, cervical screenings are usually provided by your GP. You will get a letter from your surgery inviting you to make an appointment for your screening. If you haven’t received your letter, and you know you’re due an appointment, you can contact your GP to arrange it.
When will I be invited?
In England:
age 25-49: You’ll be invited every 3 years
50-64: every 5 years
65 or older: You’ll be invited if one of your last 3 screenings showed abnormal cells
If you missed a screening appointment or you got the letter a few weeks or months ago, you can still book an appointment at any time.
Screening in different parts of the UK:
What happens in a cervical screening?
A cervical screening appointment should take about 10 minutes.
You should not have a cervical screening when you’re on your period. The blood can make the cell sample hard to test. Reschedule your appointment to a time when you won’t be bleeding.
The doctor or nurse doing your test will explain what will happen during the test and help you with any questions you have. You’ll then be given some privacy to undress from the waist down. You’ll be given a paper sheet to cover yourself with.
The clinician will then ask you to lie back on a bed. You’ll usually need to have your legs bent and knees apart. You might need to change your position during the test.
The clinician will put a speculum into your vagina. This is a smooth plastic instrument. Some lube might be used as well. They will open the speculum so that they can see your cervix.
Then they’ll insert a small soft brush and sweep it around your cervix. This collects the sample of cells.
The clinician will then close and remove the speculum, and give you time to get dressed.
The process can feel uncomfortable but it should not hurt. You might get some light bleeding or spotting after the test.
During the appointment, the clinician will tell you when you should get a letter with your results.
I’m anxious about my appointment
Anxiety can make it difficult to attend your cervical screening appointment. But there are things you can do before, during and after your appointment that might help make it a little easier.
Cervical screening for trans men and non-binary people
People who were recorded female at birth usually have a cervix and should get regular cervical screenings.
If you're registered with your GP as female, you'll be sent an invitation when you need a screening done.
If you are registered as male with your GP and you need a cervical screening you can:
contact your GP and ask if they can send you the invitations directly
put a reminder in your phone or diary and make your screening appointment at the right time for your age and where you live
Watch Fox Fisher’s experience of cervical screening as a trans man on YouTube.
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