As the NHS announce that they'll be rolling out HPV swabs - the step before smear tests - for women to do themselves at home.
Ah, smear tests. They’re almost universally feared, which, for what’s a routine cervical cancer check up that every woman needs to have, is a real shame.
As someone who’s had a smear herself, it’s easy to understand why. It’s a little uncomfortable – the nurse has to swab your cervix, after all – and you can feel a little embarrassed sat spread eagle on a doctor’s table.
But as my nurse reassured me when I had mine, the medical professionals who carry out the smears see literally hundreds of vaginas every month. It’s their job, after all. Plus, smear tests are absolutely crucial in helping you spot the early signs of cervical cancer.
“It’s a common myth that a smear test is a painful procedure. For some, it can be uncomfortable procedure, especially if you have endometriosis, vaginismus, or vaginal dryness,” shares Samantha Wild, Interim Women’s Health Clinical Lead and Primary Care Physician at Bupa Health Clinics. “But do remember that, during a smear test, you’re totally in control. If it hurts, let your nurse know – they’ll be able to help,” the doctor explains.
If you’re due a smear test, getting one for the first time, or just want to know what happens in a smear test, you’re in the right place. We’ve got expert advice from a doctor and a psychotherapist – keep reading for your smear test 101.
What happens in a smear test? Your complete guide
What is a smear test?
According to doctor Wild, a smear test – also known as cervical screening – is a test for abnormal pre-cancerous changes in the cells covering your cervix (aka, the neck of your womb). “If found, these can be treated to stop cancer developing,” she explains. “Cervical screening picks up changes in the cells that could develop into cancer in the future.”
Around 3,200 women in the UK get cervical cancer every year, yet since the national cervical screening programme was introduced in 1988, the number of women dying from cervical cancer has halved. Cervical screening saves about 4,500 lives every year in England – which is why it’s so important you get yours.
What happens in a smear test?
It’s really no where near as bad as people make out – take it from a doctor, who has carried out many in her time.
“Your smear test appointment usually lasts about ten minutes, but the actual test only takes a minute or two,” she explains.
Fun fact: you’ll be asked to take your underwear off and sit on the bed with your legs spread. Top tip here: wearing a skirt to your appointment makes the whole ordeal easier, as you’ll have ease of access and some material to cover your vaginal area, should you feel the need too. If you ask, your nurse can also provide you with some tissue paper to cover yourself with until the actual test.
Your nurse will then use an instrument called a speculum to gently open your vagina, so they can see your cervix (or neck of your womb). “They’ll, then use a small brush to take a sample of cells from your cervix,” doctor Wild explains.
Once you’re done – as above, in a short one or two minutes – the nurse will tell you to put your underwear back on and get dressed, as she bottles up your swab. From your GP, the sample will be sent a lab to be tested.
How old do you have to be to get a smear test?
As per the NHS website, in the UK, women will be invited for smear tests from the age of 25.
They say that they don’t test women under the age of 25 as it’s fairly rare for a girl to be diagnosed with cervical cancer any younger than that.
Can you get a smear test when pregnant?
Chat to your GP if you’re pregnant and called up for a smear – they should reschedule for around 12 weeks post-birth.
The smear isn’t risky for the baby or the pregnancy, but does make getting clearer results from the smear more difficult.
What does a smear test show?
The main thing smear tests are looking for is HPV, aka Human Papillomavirus. Testing for HPV is important as nearly all cases of cervical cancer are caused by the virus – as many as 90%.
Smears are the simplest way to check if you’re showing any early signs of cervical cancer or other cervical abnormalities.
“Smear tests are important as they aim to detect any abnormalities before you or your doctor notices any signs of a problem. Having regular cervical screening will identify any anomalies within your cervix cells,” doctor Wild shares.
They may not be cancerous and they may not need treatment if they’re mild, but it’s still really important to get checked regularly. Just like worries about the COVID vaccine and fertility, if you have any concern at all, do talk to your doctor – it’s their duty.
How often is a smear test?
“In the UK, you should have a smear test every three or five years, depending on your age,” explains doctor Wild. If you’re between the ages 25 to 50, you will have a cervical screening every three years, and then, after you reach 50, cervical screening takes place every five years.
She goes on to share that if your smear test results are normal, you’ll be invited back for screening every three years (or five, depending on your age). “However, if there are any abnormalities detected in your screening, you may need another smear test in a year,” the doctor adds. Basically, it’s decided on a case-by-case basis.
If your test does identify abnormal cells, you may need to have treatment to remove or destroy them. But don’t panic – your doctor will support you every step of the way.
What is the new at-home smear test?
In short, there isn’t a new at-home smear test. What are being trialed in the UK are at-home HPV tests. Health Secretary Matt Hancock has caused confusion after wrongly calling HPV swabs smear tests on Twitter.
Carrying out your own smear at home would be near impossible – you’d have to be very flexible to be able to swab your own cervix. The new swabs offer women who are skipping smears an opportunity to test if they have HPV from the comfort of their own home. Nearly all cases of cervical cancer are caused by HPV – as many as 90%. If a doctor detects HPV in your cervix, you will be asked to go in clinic for a smear.
How to prepare for a smear test
Smears have a reputation for being uncomfortable, which, subconsciously or consciously, impacts our expectation of what a smear will be like. “We assume it’ll be unpleasant,” shares registered psychotherapist and accredited counsellor Charlotte Armitage.
From a psychological perspective, this describes a cognitive framing of a smear test as a negative experience in our mind, she goes on. “We may have attached negative associations to the procedure which results in avoidance behaviours. The reality is that, aside from feeling a little exposed and some potential discomfort, smear tests are not as unpleasant as we’ve made them out to be,” she explains.
Keen to ease the anxious knot in your stomach about your upcoming smear? Don’t worry – it’s only normal to feel a little apprehensive. Let these tips from Armitage help.
1. Try and reframe the experience
If you are anxious about something, it’s likely you’ve cognitively framed the experience as negative in your mind, she shares. “It’s possible to reframe experiences and view them as more helpful manner.”
A good way to help you reframe the experience? Look at what evidence you have for the negative thoughts surrounding the smear test. Then, challenge your own thoughts, and think of a more helpful way to interpret the situation.
2. Offer yourself a reward
“It’ll enable you to focus on something to enjoy afterwards”, the psychotherapist explains.
3. Take someone with you
That is, if COVID restrictions allow. “If you are very anxious about the smear test, do take someone with you for moral support.”
4. Chat to your doctor
This one’s important – after all, it’s what they’re there for. “Communicate with the medical professional who is conducting your smear test,” shares doctor Wild. “They’ll have dealt with smear test related anxiety many times and will be equipped to help you get through it.”
5. Educate yourself
Last but by no means least, don’t avoid your smear test. “Avoidance will perpetuate the anxiety that you feel regarding the smear test. It’s likely that once you’ve had your smear test, you’ll feel less anxious about the next one.”
Another tip for countering any smear-related anxiety? Educate yourself on the importance of a smear test and the procedure itself. Remember, knowledge can be power.