Let’s talk about smear tests

Written about
21st January 2018


Photo by Chungkuk Bae on Unsplash

Not the usual for my blog, but a conversation that's more important than choosing where to eat tonight. Smear tests, Pap tests, cervical screening, whatever you want to title it, you need to get it done.

Get ready for some facts, figures and hopefully the incentive to get a smear test booked and get your mind at rest.

This year, the testing rate is at a 20 year low which genuinely shocked me to hear. That's representative of the 1 in 4 women that choose not to attend their screenings - it boggles my mind why you would turn this down. I can get my head around the nerves and apprehension that may come following your invite to be tested, however I really can't understand why you would not attend and potentially save your life, in the most extreme scenario.

For me, the test itself was really a breeze - a bit awkward, yeah, but the nurse conducting it massively helped in putting me at ease. It was over at lot faster than I'd expected and any apprehension I had beforehand almost seemed silly to have dwelled on. Obviously not everyone will have a completely easy breezy experience but in the most extreme case, a few minutes of pain (which from everyone I've spoken to and the research I've done, it's rare) is worth it to get an all clear or progress into treating something life-threatening.

Wanting to get outside of my own easy experience, I spoke to friends about what they thought, here are some of my key takeaways...

~ We are lucky to get this test free of charge in the UK, millions of women around the world don't have this luxury and we'd be doing them a disservice if we didn't take up the opportunity

~ My best friend had cervical cancer, only spotted by the screening. She's absolutely fine and cancer clear, but this test can save your life, it can save your fertility, it's bloody important.

~ Ladies go through labour. If we can go through that, we can take two minutes of discomfort

And one of my favourite sum-ups of pro smear test:

Apprehension seems to the main reason it's put off or forgotten about altogether. It's not about expecting the unexpected, it's a standard procedure that doctors and nurses carry out countless times per day.

The naming isn't the best invite, 'smear' doesn't fill me with joy either. That name will always be somewhere, but think of it as your cervical screening or the pap test (named after the good ol' doc that invented it) and maybe it'll dial down the nerves a little.

Nervous for the one on one with your practitioner? They do this every single day, numerous times. For them, it's just another day at the office. They're only human so let them know why you're nervous and more often than not, they'll be accommodating to put you at ease.

You can always make things slightly more comfortable - ask for a female to carry out the procedure, bring someone in with you for moral support, have the nurse explain in detail what will happen and why. If you're too scared to ask the questions, here's some initial info that might put your mind at rest.

What is a smear test?

The whole premise of the test is to allow abnormal cells to be detected on the cervix. Being able to spot these abnormalities as early as possible could lead to them being removed and preventing cancerous cells materialising.

The test itself is not just a test for cancer overall, it can flag a variety of abnormalities that can progress you to getting treatment and preventing further illness and discomfort.

If your test results happen to come back with abnormal cells (around 1/20 do) it does not always mean cancer. Abnormal cells are more prevalent between the ages of 30 & 45 and are much rarer under the age of 25, hence why your only invited once you're turning 25.


What happens during a smear test?

So, here's how it goes. You're in the room with the doctor or nurse conducting the examination, you get a full explanation of what will happen and the potential outcomes before anything else happens.

You're invited to get undressed behind a curtain and get on the bed. You lie with your knees up, feet touching and with disposable paper over your crotch.

Once you're ready, the nurse or doctor will begin the examination. Your knees are each laid down to the side, spreading your legs. A speculum is used to open your vagina - these are usually plastic but can sometimes be metal, so expect it to be cold. Often they will be lubricated, or you can request them to be if this makes it more comfortable for you.

The speculum is inserted and widened before a small brush is inserted to collect cells from your cervix, I could barely feel this. The nurse or doctor will then store the brush ready to send out and carefully remove the speculum, before letting you get dressed on your own behind the curtain.

Pain should be minimal (if at all), but you can ask for more lubrication or a smaller speculum if you're in discomfort. Tell the person carrying it out and they can make you as comfortable as is able.

From the time the nurse opens the curtain to begin, to the moment the curtain is closed again, took no longer than three minutes.

For me, it was discomfort free and over in a couple of minutes. For those of you that may feel discomfort, I'm sure you can agree that a couple of minutes of it is worth it to help in protecting your health later down the line.


What happens after a smear test?

You can ask your nurse or doctor how long results will take, it differs slightly depending on your practice and location. Typically, you should get your results within a two week window, often via a letter.

Your results can come via a letter, a phone call from the practice or from you calling to get them yourself. Double check before you leave your examination so you know the next steps.

Over 9/10 results come back negative - i.e. no abnormal cells and no further steps needed.

Of the 1/20 results that come back abnormal, don't assume this means you have cancer, it doesn't. Of the approx. 5 million women who get checked each year, only 3,000 of these cases result in cervical cancer diagnosis. In the grand scheme, it's pretty unlikely, but should you be one of the 3,000 the earlier you're diagnosed, the more can be done, depending on your condition.

Cervical screenings are 80-90% reliable, so of those women that would have developed cervical cancer, it means 7/10 can be prevented.


My whole reasoning behind putting this post together is to help some of you feel more relaxed about the experience or just push you into booking the test. Honestly, for the vast majority of people, the thought of it is a lot scarier than the examination itself.

If we're going tough love, it's a suck it up and get it done vibe.

This is entirely pro-smear test and honestly, I don't have much evidence for the counter argument. Nobody deserves to have a terrible experience for such a personal and important examination, in reality there's always a bad experience from someone to share, but the small minority of bad experiences shouldn't be the overall consensus for how it goes.

If you're still looking for more info, the below are what helped me write this piece and are a treasure trove for FAQs, what happens before, during and after. Get educated and it might help in putting your mind at ease: