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Smear tests and HPV: what screening checks and how often

A smear test (cervical screening) is not a test for cancer, but a test that helps to prevent cervical cancer. According to the NHS, the sample of cells is first tested for high-risk types of HPV – the virus that causes almost all cases of this cancer – and only if it is found are the cells also checked for changes. In the UK programme, women aged 25 to 64 are invited every 5 years, and if HPV is found the interval is shortened to 1 year.

What exactly does a smear test check?

According to the NHS, screening checks the health of the cervix – the opening between the vagina and the womb. It does not look for cancer, but helps to prevent it: it finds changes in the cells that can be treated before they develop into cancer.

The process has two steps. A small sample of cells is first tested for certain high-risk types of human papillomavirus (HPV), which can cause changes in the cells. If no such virus is found, no further tests are done. If it is found, the same sample is also checked for changes in the cells of the cervix.

What is HPV and how is it passed on?

The NHS describes HPV as a very common group of viruses – most people will get some type of it in their lifetime. It is passed on through any skin-to-skin contact in the genital area, not just penetrative sex: vaginal, oral or anal sex, other genital contact and sharing sex toys.

In most cases the body clears the virus without consequences, but sometimes it stays for a long time. It is the persistent high-risk types that can cause changes in the cells which, without treatment, can become cancer. According to the NHS, without a high-risk type of HPV, cervical cancer is very unlikely – even if you have had abnormal cells in the past.

At what age and how often is screening done?

In the UK programme that the NHS describes, all women aged 25 to 64 are invited for screening every 5 years. The NHS stresses that everyone with a cervix should go for screening.

According to the NHS, you remain at risk and should attend even if you have been vaccinated against HPV (the vaccine does not cover all types), you have only had one partner, you have been with the same partner for a long time or have not had sex for a long time, you are a lesbian or bisexual, or you have had a partial hysterectomy in which the cervix was not completely removed. If you have never had sexual contact, your risk is low, but the NHS still recommends going when you are invited.

What happens at the appointment itself?

The NHS describes the appointment step by step. It is usually done by a woman – a nurse or doctor, who first explains the test. You undress from the waist down behind a screen and lie on a couch, usually with your knees bent. A smooth speculum is gently inserted into the vagina, with lubricant if needed, and opened so the cervix can be seen. A small sample of cells is taken with a soft brush, after which the speculum is removed.

The test itself takes under 5 minutes, the whole appointment – around 10. It does not usually hurt, but for some women it is uncomfortable or painful. You can ask to stop at any time, ask for a smaller speculum, a different position (for example on your side with your knees bent) or to insert the speculum yourself. Light bleeding afterwards is normal and should stop within a few hours.

What do the results mean?

According to the NHS, there are four main outcomes:

• HPV not found – the risk of cervical cancer is very low; no further tests are needed, next invitation in 5 years.
• Unclear (inadequate) result – a repeat test after 3 months; this does not mean something is wrong.
• HPV found, no cell changes – a new invitation after 1 year and another a year after that if the virus is still there. If HPV persists for 2 years, a colposcopy is arranged.
• HPV found with cell changes – a colposcopy is arranged.

A colposcopy is a simple procedure to look at the cervix, similar to screening but done in hospital. The NHS points out that the cell changes will not get worse while you wait for it. A positive HPV result does not mean infidelity – the virus can stay in the body for many years without a new partner.

When should you see a doctor?

According to the NHS, contact a doctor or nurse:

• if you are not sure whether you need to go for screening – for example after a hysterectomy or if you have never had sexual contact;
• if you have heavy bleeding after the appointment, or spotting does not stop after a few hours;
• if your results are late beyond the date you were told – call the surgery;
• if you have worrying symptoms – do not wait for your screening invitation, contact your doctor;
• if you are a trans man or a non-binary person with a cervix and are not receiving invitations – you can ask to be included.

Frequently asked questions

Sources

• NHS – Why cervical screening is done – last reviewed by the NHS: 26 June 2025
• NHS – Your cervical screening results – last reviewed by the NHS: 26 June 2025
• NHS – What happens at your cervical screening appointment – last reviewed by the NHS: 26 June 2025

Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].

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