Cervical screening is not a test for cancer. It is a test to check the health of the cervix. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman's cervix (the neck of the womb).
The first stage in cervical screening is taking a sample of cells from the cervix. This is taken using a method known as liquid based cytology (LBC). Since 2008, liquid based cytology has replaced the conventional method of smear testing. A doctor or nurse uses a small instrument called a speculum to gently open the vagina. A small brush is then used to sweep around the cervix to take a sample of cells. Rather than smearing the sample onto a microscope slide as happened with the conventional smear, the head of the brush, where the cells are lodged, is broken off into a small container of preservative fluid, or rinsed directly into the preservative fluid. The sample is then sent to the laboratory to be examined under a microscope (for more information see the NHS Cancer Screening Programme's leaftet 'The Facts').
Some women find cervical screening an easier procedure than others. Most consider the procedure to be only mildly uncomfortable. Some felt the procedure was an intrusion or they felt vulnerable, others found the procedure undignified and unpleasant. Despite these feelings many said it was important to attend for cervical screening to know that their cervix was healthy.
Some women said they make their appointment for cervical screening in the morning after they have showered so that they feel fresh and confident. One woman said that being provided with a gown helped to maintain her modesty. Others said that they wore a skirt when they attended for a screening test which enabled them to partly cover themselves and to feel less exposed. Another tried not to think about the procedure too much which helped her to overcome feelings of embarrassment. A few found it helpful to remember that the person taking the test had experience of taking many cervical screening tests and they did not find it embarrassing.
There are various information leaflets produced by the NHS Screening Programme and other organisations about cervical screening and follow-up. Leaflets about cervical screening were available at the surgery and were sometimes given to women by the practice nurse, or in other cases, were sent to women with the invitation letter for their screening test.
One young woman explained how she felt less anxious than she might have done about having her first screening test because the nurse had given her a leaflet beforehand and explained to her exactly what the test would involve. Most women were given opportunities during their cervical screening appointment to ask questions about the test. All women should receive a leaflet with their invitation.
Some of the younger women were given an explanation of the test procedure and the instruments used. One woman explains how she found it helpful to be shown the speculum used to open the vagina during the test.
Some older women had been given explanations about the effect of the menopause on hormone levels, and how this can cause dryness and make it more difficult to insert the speculum or cause some bleeding. One woman explains how she was told by the nurse that getting sufficient cervical cells during cervical screening can sometimes be more difficult in women who had gone through the menopause. The new method of liquid based cytology has reduced the number of inadequate test results and women are less likely to need to return for a second test.
With the traditional method of screening, some women found the test mildly uncomfortable, but not painful. In some cases, when the cells were taken or the need to change the size of the speculum or to re-adjust the position of the speculum to see the cervix properly were described as causing pain. Some found the procedure less painful when the nurse or doctor had used KY jelly to help insert the speculum in to the vagina and many said the speculum was cold. The new method of taking the test using liquid-based cytology reduced the level of discomfort some women experienced, because the procedure is much quicker and a brush is used to gently brush cells from the cervix.
Women who had found it easier to relax were more likely to describe the test as slightly uncomfortable rather than painful. Some found that familiarity with the test, or having children, had made the test less unpleasant.
Many commented that although they had experienced embarrassment or painful screening tests in the past they considered it very important to attend for cervical screening.
Although most women said they prefer to have a woman undertake the test, some women had no preference and a minority preferred a male doctor. Some preferred a doctor rather than a nurse. Others preferred a nurse because they felt more comfortable or they didn't have to wait too long for an appointment. One woman who had a previous bad experience preferred to have her screening test undertaken by a doctor or nurse that she trusted.
While some women wanted to have cervical screening taken by someone they were familiar with, others felt that too much familiarity would increase their embarrassment. A practitioner who was sensitive, and provided time for explanation and information was important for many women in their decisions to return a second time for cervical screening.
Last reviewed January 2011.
Last updated February 2011.
