Cervical screening
Cervical screening is offered to women aged between 25 and 64 to prevent cervical cancer. The screening test or 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).
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 go 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 go for 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.
- Belfast Health and Social Care Trust
- Northern Health and Social Care Trust
- South Eastern Health and Social Care Trust
- Southern Health and Social Care Trust
- Western Health and Social Care Trust
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 then sent for investigations in the laboratory.
Temporary changes to how samples are processed
Temporary changes to the way cervical screening samples are processed in the laboratory were introduced in March 2023.
This is to manage the current backlog caused by a shortage of qualified staff to examine the samples.
Samples are being tested in a two-step process as follows.
- step one: human papillomavirus (HPV) testing
- step two: cytology investigation (examination under a microscope)
Step one will be used to prioritise samples for cytology. Samples which test positive for HPV will be examined first.
If the sample tests negative for HPV the chances of a patient developing a cancer are very low.
However, all specimens will still undergo cytology.
This process aims to manage the clinical risk caused by delays in cytology investigations by identifying those patients who are at higher risk of cervical cancer.
This will help make sure that patients with abnormal cell changes can be identified as early as possible. There are no changes to the clinical procedure for taking a sample.
Testing for HPV is an effective and accurate way of identifying women at risk of cell abnormalities.
Having HPV, or cell changes, does not mean you have cervical cancer.
Cervical screening is offered to help prevent cancer.
Further information about HPV can be found at:
Further information about the temporary changes to the Cervical Screening Programme can be found at:
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.
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.
Waiting for your screening invite
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
These are usually caused by something other than cancer but it’s important to have them checked.
Cervical screening results
Your result will be sent to your doctor when the lab report is complete.
A complete lab report requires both the HPV test and the cytology (microscope examination)to have been done.
This can take on average up to 12 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.
Depending on the results of both the HPV test and the cytology test, you may be referred for a further investigation at a hospital clinic, called colposcopy.
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.