Patient information · Women's health
Cervical screening
what the test now looks for, and what results mean
Cervical screening has changed. Samples are now tested first for high-risk HPV, and cells are only examined if HPV is found. This is more accurate than the old method, but it produces result letters that confuse people — particularly the one saying HPV was found but the cells are normal.
Do not wait for your next screening invitation if you have
- bleeding between periods, or after sex
- any bleeding after the menopause
- persistent unusual discharge, particularly if bloodstained or offensive
- persistent pelvic pain, or pain during sex
- any of these symptoms even with a recent normal smear
Screening is for people without symptoms. A normal smear does not exclude cancer in someone who has symptoms, and symptoms need investigating separately and promptly.
How it works now
Almost all cervical cancer is caused by persistent infection with high-risk HPV, a very common virus that most people acquire at some point and clear without ever knowing. Testing for the virus first identifies who is at risk far more reliably than looking at cells alone, which is why intervals have safely lengthened for those who test negative.
Understanding your result
- HPV not found — your risk is very low. Next test at the routine interval. This is the great majority of results.
- HPV found, cell changes not found — you have the virus but it has not caused any change. Most people clear it. You will be invited back in 12 months to see whether it has gone. This is not cancer and is not an emergency, though the letter causes a great deal of alarm.
- HPV found, cell changes found — referral for colposcopy, a closer look at the cervix. Cell changes are not cancer; they are changes that could, over many years, develop into it, which is exactly what treatment prevents.
- Inadequate sample — repeat in about three months. Common, and not a sign anything is wrong.
Having HPV says nothing about your relationships
HPV is transmitted by skin contact, is extremely common, can lie dormant for years or decades, and can be detected long after the exposure that caused it. A positive result tells you nothing about when you acquired it or from whom, and it is not a reason for suspicion or blame. Around eight in ten people are infected at some point.
Making the test easier
Helps
- Booking mid-cycle, avoiding your period
- Asking for a smaller speculum — you can simply request one
- Asking to insert the speculum yourself
- Bringing someone with you, or asking for a chaperone
- Telling us if you have had a difficult experience, been through trauma, or have vaginismus — we can adapt
Not required
- There is no need to shave or do anything special
- You do not need to be in a relationship, or sexually active recently
- Same-sex partners and trans men still need screening if you have a cervix
- Being past menopause does not stop screening until 65
- A previous normal result does not make the next one unnecessary
Particular situations
- Pregnancy — routine screening is usually deferred until about 12 weeks after delivery, unless you are due follow-up of a previous abnormality.
- After a hysterectomy — whether you still need screening depends on whether the cervix was removed and why.
- HPV vaccinated — you still need screening. The vaccine covers the commonest high-risk types, not all of them.
- Over 65 — screening stops if recent tests were normal, but you can request one if you have never been screened or have symptoms.
Book an appointment if you are due or overdue, you want your test done without waiting, you found a previous test difficult, or you have had a result letter you do not understand. We offer unhurried appointments with time to talk it through, and results without a long wait.
Screening without the wait
Unhurried women's health appointments seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.