Cervical Screening Q&A: Dr Victoria Fielding

Q1. What is a smear test?

A. Many women will be familiar with what a cervical screen or cervical smear is as part of the NHS screening programme. Basically, it's a check to see how healthy your cervix is. And here at the McIndoe, we offer the service to all women over the age of 18. And it's essentially what we are doing is taking a small sample of cells from the end of your cervix. We are looking for the human papillomavirus, otherwise known as HPV, and we're also looking at those cells under the microscope to identify any changes that we might see, and those early changes can go on to develop into cervical cancer. And the really positive thing about having a cervical smear is if we identify those little cells that have started to change, we can treat them so that you never go on to develop cervical cancer.

Q2. Why should I have a smear test?

A. Cervical cancer is a really important cancer to be aware of. Globally It's the fourth most common in women, and about 3,300 women are diagnosed, with cervical cancer in the UK every year. Somewhat surprisingly, the most common age to get diagnosed is between 30 and 34. Almost all cases of cervical cancer are caused by the human papillomavirus, HPV—a really important virus to be aware of, to get vaccinated for if you're eligible, and to come and have regular cervical screens.

Q3. What happens during a cervical screening?

A. You'd come into our reception initially, you'd register with them to let us know that you've arrived. We'd welcome you into one of our consultation rooms like this one, and you would meet with a GP and one of our nurses who would be my chaperone. Then we'd have a discussion about what was going to happen during the procedure. And we get you to undress in some privacy, and come back into the room when you are ready. What would happen next is I would use a speculum with some lubricant on the end of it, which is inserted into your vagina. It allows me to visualise your cervix, make sure it looks healthy. That's my first initial check. Then I would use a small cervical brush to take a sample of the cells at the end of your cervix for your cervical smear. And that's it. You're done.

I totally understand that some women can feel very worried and anxious about attending for a cervical smear. I've learnt over time not to underestimate the importance of feeling comfortable in your environment with the people who are doing the test, making sure that you've got time. All of those things are really key for a successful procedure. Some women find it uncomfortable. There are various techniques I have got to try and help with that. And it's also about being honest with the clinicians around you, saying stop when you want to, and knowing that you have the power to say stop.

Q4. What do smear test results mean?

If your results are normal, those will be communicated via email or post to you. If your results are positive, that could be that we've identified the human papillomavirus, that HPV virus, or we've seen that some of those cells that we've taken from the end of your cervix have started to change. We can talk through next steps, and I would call you to discuss that. It might be that we just recommend you to have a smear a little bit earlier, perhaps in a year's time, or that we need you to be seen by a colposcopist, a specialist gynaecologist who will examine your cervix in more detail, and I would refer you on for that, whether that's via the NHS or privately.

Q5. When is a smear test not recommended?

Our cervical smears are open to women over the age of 18. Important to note, it's women who have a cervix. So if you've had a total hysterectomy and no longer have a cervix, you do not need cervical smears. I wouldn't want to see anybody that was pregnant or had been pregnant, had a miscarriage or termination within three months. And I also wouldn't want to repeat a smear if you'd had one in the past three months. You need to wait at least three months between the tests.