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The Smear Test

What is a smear test?

A smear test is taken to check for changes in the cells of your cervix.
The cervix is the lower part of the uterus that opens the vagina. Developed in the 1940s by Dr. George Papanicolaou, this test (sometimes called a Pap smear) can help to detect cervical cancer at an early stage. Around 1,500 women in the UK die from cervical cancer every year. The smear test is credited with saving tens of thousands of women’s lives and decreasing deaths from cervical cancer by more than 70%. The smear test can also spot infections which may need treating.

Who needs it?

Every woman should have a smear test. All women between the ages of 20 and 64 are eligible to a free cervical smear test every 3-5 years according to local health authority. If you have any doubts about whether you need to be tested, consult your doctor.

When should I have it?

If you are eligible for a smear test and have not had one within at least 3-5 years, arrange to have one as soon as possible. Your smear test should be taken at least 5 days after the end of your period (if you’re still having periods) your doctor may send you a reminder when your test is due, so do let the practice know if you change your address.

Where can I have it done?

At a doctors’ surgery or family planning clinic. If you would prefer a women doctor, you can find out either from your GP or family planning clinic (listed in the phone book) when women doctors are available. However, if you have a male doctor please do not be embarrassed as this kind of examination is routine practice.

How do I prepare for a smear?

You should avoid using vaginal creams, having intercourse, or applying a lubricant jelly 24 hours before the test because it could cause inaccurate test results. You should tell your doctor if you have had an abnormal smear, if you think you might be pregnant, and if you are taking any medications or oral contraceptive.

What happens during the procedure?

A smear test only takes a few minutes. You will be asked to remove your pants and lie down on the couch, on your back or side, with your knees bent and legs apart. A device called a speculum is gently inserted into your vagina and opened slightly so that the cervix (neck of the womb) can be seen. Then a spatula will be rubbed against the cervix to take a sample of some of the cells. The sample will then be spread on to microscope slide and sent the laboratory for analysis. There are no risks involved in the test. However, you may experience some discomfort and a feeling of pressure during the procedure. A small amount of bleeding may occur after the test.

What happens after the procedure?

You may be sent your results or you may have to ask for them. Either way, it will take a number of weeks. If the cells appear normal, no treatment is necessary. If an infection is present, treatment is prescribed. If the cells appear abnormal, more test may be necessary.

What does it mean if I’m called back?

Only very rarely does it mean that you have cancer. It might simply mean that your sample didn’t show up clearly, for example not enough cells may have been collected, and that another smear is needed. This is called an unsatisfactory result. On the other hand, your results could point to some slight changes in the cells of the cervix. If abnormal changes, known as dyskaryosis, are detected, you will have what is called an abnormal result.

What happens if I get an abnormal result?

Your doctor will explain what needs to be done, for example, you may be asked to come back for more smear results. Often the cells return to normal by themselves, but if the repeat smear test still shows abnormal cells, you may be asked to go to a hospital for a closer examination. Treatment, if needed, is virtually 100% effective. It is a minor procedure, usually done on an outpatient basis.

Terms used for test results

Negative- this means that the test results is normal and no abnormal cells were present
Infection- the result shows that there is some infection in this area which requires treatment. A further investigation is necessary which will involve another test.
Repeat- a repeat test may be needed. This is not unusually because of abnormal cells but because of minor infections, or it may be that not enough cells were collected for the test.
Abnormal cells- this does not necessarily mean cancer but more tests will be required. These can be done in the outpatient clinic at the hospital and their purpose is to provide the doctor with a more complete picture of any possible problem.
If there is anything about your results you do not understand, your doctor will be happy to explain it to you.

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