Cervical cancer

Even if you expect everything’s fine, don’t ignore your smear test invite. It can help stop cervical cancer before it starts


  1. Every day, two women in the UK die from cervical cancer.
  2. The test only takes five minutes, but it could stop cervical cancer before it starts.
  3. Even if you've had your HPV vaccine, the test is your best protection against cervical cancer.
  4. The test checks the cells from your cervix for HPV. HPV causes 99% of cervical cancers but has no symptoms.

Why get checked early?

In Scotland, anyone aged 25 to 64 with a cervix is invited for a cervical screening (smear) test - even if they’ve had the HPV (human papillomavirus) vaccine. It only takes 5 minutes, and it’s the best thing you can do to stop cervical cancer before it starts.

The test checks the cells from your cervix for HPV - the main cause of cervical cancer. If HPV is found, your sample is then checked for cell changes. It is the most effective and accurate way of finding out if you’re more likely to develop cervical cancer, so you only need to attend every five years.

Even if you expect everything’s fine, the test can detect any cell changes early on. And the earlier cervical cancer is found, the easier it is to treat. In fact, you’re nine times more likely to survive cervical cancer when it’s found at an early stage, compared to a later stage.

Don’t ignore it

A cervical screening (smear) test can be nerve-wracking, stressful or just inconvenient. Whether it’s your first one or you’ve been for one before, everyone has their own reasons for putting it off. But even if you expect everything’s fine, don’t ignore your smear test invite. Cervical cancer is the most common cancer in women under 35 in Scotland, and a smear test can help stop it before it starts

If you’re worried, here are a few things you can do to feel a little calmer on the day:

  • If you feel comfortable wearing a skirt or dress, it may help you feel more covered. You can keep it on during the test and only take off your underwear.
  • Ask for a nurse or doctor of a particular gender. You may feel more comfortable knowing that a female or male nurse will be doing your cervical screening.
  • Speculums come in different sizes. If you find the standard size too uncomfortable, you can ask to try another size.
  • Lying on your back may feel uncomfortable for lots of reasons. You can ask to lie on your left-hand side with your knees bent.
  • If you have gone through or are going through the menopause, it can sometimes make the test more uncomfortable. You can ask your nurse or doctor to prescribe you a vaginal oestrogen cream or pessary, which may help.

And always remember, the nurse or doctor are there to help. So ask any questions you want and take it as slow as you like. For more tips, visit Our cervical screening tips | Jo's Cervical Cancer Trust (jostrust.org.uk)

Cervical screening is still taking place in Scotland. You’ll just need to wear a face mask unless you’re exempt. If you have any concerns around screening and COVID-19, please visit Coronavirus (COVID-19): Immunisation and screening | NHS inform


A specialist's view

I’ve done hundreds, if not thousands, of smear tests during my career so far. It can be a nervous time for some women so I do what I can to put them at ease and always remind them that there’s no such thing as a silly question.

Afterwards, most women – especially those that have gone for the first time - are surprised by how quickly it’s all over. It takes just minutes, and could stop cancer before it starts, so I’d encourage all women to think twice before they add their invite to a pile of unopened mail or forget about it completely.

Remember, there are practice nurses and GPs across Scotland, just like me, waiting to help protect you from cervical cancer.

Mary Horne, Practice Nurse, NHS Lothian

Am I expected to go for a cervical screening (smear) test if…

I only have sex with women?

Yes. The types of HPV that can cause changes in the cells of your cervix are transmitted through any sexual contact. This includes penetrative sex and other types of sexual activity, such as skin-to-skin contact of the genital area or using sex toys.

I’ve had the HPV vaccine?

The vaccine doesn’t protect against all types of HPV and will not protect against any HPV infections you picked up before you had the vaccine. So although the vaccine offers good protection, it’s still important to attend for regular smear tests.

I haven’t been sexually active for a long time?

Many people have HPV for months or years without knowing it. So it’s important that you have regular screening tests if you have ever been sexually active.

I’ve been through the menopause?

You still need to check if your cervix is healthy. Sometimes the test may be more uncomfortable because of dryness in the vagina after menopause. But your nurse or GP will have ways to reduce discomfort, such as using a smaller speculum.

I’m pregnant?

You may not need a test. If you’re pregnant or have a new baby, tell your nurse or GP when you’re invited for a smear test.

I’ve had a hysterectomy?

You may not need a test depending on the type of hysterectomy you had. Check with your nurse or GP before making an appointment.

I'm transgender or a non-binary person?

This will depend on whether you have a cervix or not.  To understand more about what screening services you’re eligible for, visit: www.nhsinform.scot/transscreening

I have HIV?

If you have HIV, you’ll be invited for a cervical screening test every year. HIV can make your immune system very weak, meaning it’s not as able to get rid of the types of HPV that cause most cervical cancers. Speak to your GP, nurse or specialist about this.

I’m in a long-term relationship?

Yes. You can have HPV for many years without knowing it and you can get it during your first sexual contact. So regular cervical screening is still important even if you’ve been with the same person for a long time.

I’ve never had sex before?

If you’ve never been sexually active there’s a lower chance of you having HPV. But remember, being sexually active includes penetrative sex and other types of sexual contact, such as skin-to-skin contact of the genital area or using sex toys.  Speak to a health professional if you’re unsure.

What are the symptoms of cervical cancer?

There are usually no symptoms of HPV or with changes in cervical cells. Four out of five people in Scotland will have HPV at some point in their lives. It’ll usually be cleared by the body itself in time. But some types can lead to cervical cancer. That’s why it’s really important to attend your smear test when invited.

However, if you notice any of the following symptoms between tests, make an appointment with your GP practice as soon as possible:

  • Abnormal bleeding: during or after sexual intercourse, or between periods
  • Post-menopausal bleeding: if you are not on HRT or have stopped it for six weeks
  • Unusual and/or unpleasant vaginal discharge
  • Discomfort or pain during sex
  • Lower back pain

There are many other conditions that could cause these symptoms. So while it’s probably nothing to worry about, you should contact your GP. Whatever it is, the earlier it’s found the easier it will be to treat.

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