How to make cervical screening (a smear test) work for you

Nearly a third of eligible people in England did not come forward for a cervical screening in 2023.

Cervical screening, which some people refer to as  ’going for a smear test’, checks the health of the cervix and helps prevent cervical cancer.

Healthwatch England’s new research shows many people put off going for cervical screening due to physical discomfort, embarrassment to undress and a belief they don’t need to attend as they aren’t currently sexually active.

In this post, we answer some of the key questions about cervical screening and the adjustments you can ask for to improve the experience of your screening appointment.

Do I have to attend cervical screening? 

Attending a cervical screening appointment is your choice. However, the NHS highly recommends everyone with a cervix attend screenings, as they are vital to prevent cervical cancer.

Knowing what support is available and adjustments you can ask for may make it a more pleasant experience if you are worried about attending.

How is cervical screening done? 

According to information on the NHS website, a nurse or doctor will use a soft brush to collect a small sample of cells from your cervix. The sample is checked for human papillomavirus (HPV), which can cause changes to the cells of your cervix. The process is quick; it usually takes about five minutes. Check out this  NHS video showing someone having a cervical screening.

Your cervical screening results are usually sent to you in a letter. Your nurse or doctor will tell you when you can expect your results.

What should I consider before booking my cervical screening appointment? 

You do not need to do anything special to prepare, but some things may help, the NHS website says:

• Book your screening for when you’re not having a period – this includes the two days before or after you bleed.
• Wait until after any treatment for unusual vaginal discharge or a pelvic infection.
• Avoid vaginal medicines, lubricants and creams for two days before your appointment.

What cervical screening support is available? 

You may feel anxious or worried about attending for several reasons. If you feel concerned about your appointment, you can discuss this with a health professional who can help when booking the appointment. Some adjustments you can ask for  include:

• Book the first appointment of the day to avoid waiting in waiting rooms for a long time.
• Ask to be seen by a trusted doctor or female health professional.
• Ask for a chaperone. This is usually another health professional, although you can also bring a friend, relative or carer.
• Ask for a longer appointment if you feel you may need more time during the appointment.
• Ask for an appointment, just to talk about what happens during the screening first.
• Ask for a vaginal oestrogen cream or pessary to be prescribed ahead of your appointment, if you think screening may be more difficult after menopause.

What adjustments can be made during the appointment to make it more comfortable? 

There are a number of adjustments you can ask for during your cervical screening. These include:

• If you feel uncomfortable during your screening or are worried about removing your clothes, you can wear a skirt, dress or long top. This may help you to feel more covered, as you can keep these clothes on during your test and will only be asked to take off your underwear. Health professionals will always give you a modesty sheet to cover you.
• You may feel more comfortable in different positions, like lying on your side. Your doctor or nurse will work with you to make sure you’re in the best position for yourself.
• You can also ask for a smaller speculum. Health professionals will use a speculum to see your cervix. They come in a range of sizes. You can talk to your health professional about which size suits you best.
• It may help to agree on a word or hand signal during the test, so the health professional knows to stop if you need a break or feel uncomfortable.