Cervical screening

Cervical screening is offered to women aged between 25 and 64 to prevent cervical cancer. The screening test, often called a smear test, detects early pre-cancerous changes in cells that line the cervix. Most changes are caused by persistent infection with high risk types of the human papillomavirus (HPV). Changes can be monitored or treated.

Cervical screening and coronavirus

When you will receive a screening invitation

As a result of Coronavirus (COVID-19), all invitations for the cervical cancer screening programme were paused from the week beginning 16 March 2020.

The programme resumed in June 2020, initially inviting those women who may be at higher risk of cervical changes. This includes those who had a previous abnormal result, or those who were waiting to have their test repeated.

Routine invitations recommenced in August 2020, beginning with those who were due a test in April 2020.

All routine invites continue to be delayed by several months until the programme has the opportunity to catch up.

Your safety when attending a screening test

When you make your appointment, your GP practice will be able to advise you on all the steps they are taking to keep you and their staff safe at this time.

You will be asked to wear a face covering when you attend, they may limit the number of people in the waiting area or you may have to wait outside until the time of your appointment. Your actual screening test will be carried out exactly as before.

If you have symptoms of coronavirus, or have been in contact with someone who does, you must not go to your cervical screening appointment.  Contact your GP practice and let them know you have coronavirus symptoms. Your appointment can be rearranged for a time after you have isolated.

What to do while you wait for your screening invite

While you wait for your invite it is important to be symptom aware.

You should report any symptoms such as unusual discharge or bleeding to your doctor as soon as possible. This includes bleeding after sex, between periods or after the menopause. These are usually caused by something other than cancer but it’s important to have them checked.

Attending a colposcopy appointment for further assessment or treatment

Colposcopy clinics have continued to be held where possible. The Trust will advise you on any special measures they are taking to keep you and their staff safe from coronavirus. You will need to wear a face covering when you attend for your appointment.

Potential risks associated with delaying your cervical screening test

Cervical screening is not a test for cancer, but for changes to cells in your cervix which, without treatment, can sometimes develop into cervical cancer.  These cell changes usually take many years to develop, so it is unlikely that a short delay in having a cervical screening test will affect most individual outcomes.

Speak to someone at your GP surgery, even if you have had a normal screening test, if you have any symptoms, such as:

  • vaginal bleeding after sex, between periods or after the menopause
  • vaginal discharge that is not normal for you
  • persistent back or tummy pains, or pain during sex

Northern Ireland Cervical Screening Programme

The cervical screening programme is for women who have no symptoms of disease. All women registered with a GP in Northern Ireland who fall within the screening age range are automatically invited to attend for a screening test.

Women aged between 25 and 49 are invited every three years and women aged between 50 and 64 are invited every five years.

Make sure your GP has your correct name and address so you receive your invitation for screening.

Cervical screening information video

A video showing what you can expect when you get invited to attend cervical screening can be found at the link below:

This video is also available in:

How reliable is cervical screening

Screening will pick up most changes in the cervix but can’t find them all. Changes can also happen between tests so you should contact your GP if you are concerned about symptoms at any time.

Where to have cervical screening

Screening is usually carried out by a nurse at your GP practice. You may be able to have the test at a sexual and reproductive health clinic. Contact your local Health and Social Care Trust for more details.

What happens at a screening appointment

A screening test takes about 10 minutes. You’ll be asked to undress from the waist down and lie on your back, with your knees drawn up and apart. Your lower body will be covered with a sheet.

The nurse will insert a speculum into your vagina to hold it open. A small soft brush is used to pick up a sample of cells from your cervix. This might be a little uncomfortable but shouldn't be painful.

The sample is sent to the lab, for examination. It may also be tested for the presence of high risk HPV.

Cervical screening results

Results should be available within four weeks. In nine out of ten cases the results will show no changes to cells in the cervix. These women will be invited for screening again in three or five years’ time.

Sometimes there are not enough cells in the sample for the lab to examine. This happens in about three in every 100 tests. In this case you will be asked to return for a repeat test in three months’ time.

If the result shows minor changes in the cells, the sample will also be tested for high risk types of HPV. If there is no HPV, the risk of significant cervical disease is very low and no further investigations will be needed at this time.

If HPV is found, or the changes in the cells need further investigation, you will be referred to a colposcopy clinic for examination. A result showing changes in the cells is common, but doesn’t mean you have cervical cancer.

Colposcopy examination

A colposcopy is an examination of the cervix with a type of magnifying glass. It lets the doctor or nurse look more closely at the changes on the cervix to decide if treatment is needed.

The examination is similar to the screening test and takes about 15 minutes. You should allow up to an hour for the whole visit. This will include consultation with the colposcopist about the procedure and a nurse will be present to assist you during the examination.

A small sample of tissue (biopsy) may be taken from an area of the cervix during the procedure. This may be uncomfortable but shouldn’t be painful.

The colposcopist will explain if you need any treatment. Sometimes this can be done at the time of your colposcopy, or you may be asked to come back when the results of the biopsy are available.

The treatment is usually simple and can be done under local anaesthetic. The choice of treatment will depend on your case.

Follow-up after treatment

Around six months after treatment, you will usually be offered another screening test to check your treatment has been successful. This test will be carried out at the hospital clinic.

Although one in five women are invited back for another colposcopy, only a few will need further treatment. This is because it can take longer than six months for your immune system to clear HPV after treatment.

Your hospital team will keep you under review until they think you can safely return to routine screening tests.

What happens to your sample and data

All cervical screening slides are kept by the lab for 10 years. Staff working for the screening programme may see and review your records as a way to monitor and improve the quality of the screening programme and the expertise of the specialist staff. Any information about you will stay strictly confidential.

If you are diagnosed with cervical cancer, your previous screening history and results will be reviewed.  You will be able to see the results of this review if you wish.

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