If you make one resolution for 2021, promise to take better care of yourself – especially if you have a cervix. For context, your cervix is an opening that connects your vagina to your uterus and if you’re under the age of 25 it probably isn’t something you think about that often. However, once you hit 25, your cervical health is something you should be paying attention to.
What is a smear test?
If you live in the UK and you’re 25, you’ll receive a letter inviting you to a cervical screening. Also known as a smear test or pap smear, this is a quick procedure in which a medical professional will use a small swab to gather cells from your cervix to check for particular strains of human papillomavirus (HPV). Girls are now being vaccinated against HPV and for the most part, our bodies are able to fight more threatening strains off. However, staying up to date with your screenings is the best way to prevent a strain that could turn into cervical cancer.
“Thankfully, cervical cancer is very rare in under 25s, but it’s common to have cell changes when you are young which will often go away by themselves. Testing under 25s is likely to lead to unnecessary treatment, which can come with risks and side effects. It’s still so important that everyone, regardless of age, is aware of the symptoms of cervical cancer and to always let your GP know if you are experiencing them.” says Imogen Pinnell, Health Information Manager at Jo’s Cervical Cancer Trust.
I’m anxious about my smear test
Fear and anxiety is the main factor putting people off cervical checks and this is a problem. Because sure, lying on a table with your legs apart while a nurse takes a swab of your cervix isn’t the most enjoyable experience, but these quick tests are lifesaving procedures, and that’s why anyone with a cervix should be booking a check.
“Smear tests save thousands of lives every year by detecting who is at higher risk of developing cervical cell changes or cancer.” says Imogen Pinnell. “Around 220,000 people will be told that they have cell changes every year in the UK. Some will be offered treatment to stop these cells turning into cancer, however others might just be monitored more closely.”
Smear tests are the best protection against cervical cancer but they aren’t always easygoing. Scant education about what a test entails and what to expect when you have one means many people feel underprepared, anxious and embarrassed about having one.
There’s no denying that having a cervical screening for the first time is a nerve wracking experience. Even the name isn’t particularly pleasant and the procedure itself, although quick and routine, can feel strange and uncomfortable. However, it shouldn’t hurt and you’ll always be safe throughout.
Taking deep breaths, listening to music, bringing a friend with you for support, and avoiding coffee, alcohol, sugar or anything that may bring on palpitations the day of your screening will help to reduce your anxiety. Some people find it useful to practise brain-training games or reciting something they’ve learnt by heart to focus their mind during the screening, while others prefer to drink a calming tea beforehand and close their eyes and listen to a podcast during the exam.
If you take anti-anxiety medication, taking something before the screening can help with nerves, but you can also ask the nurse carrying out the check for something if you’re really struggling. It’s important to remember that nothing bad will happen to you during a screening and that your fear is something that you bring to the experience and that you can leave at the door.
What happens during a cervical screening?
Once you’ve checked yourself in at the clinic, you’ll be called in and the nurse or medical professional carrying out the screening will explain what’s about to happen. This is your opportunity to ask questions, so if there’s something you’d like to know, use the opportunity. You may also want to let the person carrying out the test know that you feel anxious and ask them to describe what’s happening while it’s taking place or do something else to make you feel more comfortable.
Then you’ll be left to privately remove the bottom half of your clothing and underwear – you can keep your socks on if it makes you feel more comfortable. Next it’s time to lie down on the table and cover yourself up with the sterile cloth provided. The nurse will come back in, ask you to place your legs apart and relax. They’ll use a tool called a speculum, with some lubricant, and this will be gently inserted into the vagina. If you haven’t had penetrative sex before, or if you’re uncomfortable having something inside, ask for the smallest size.
The speculum opens slightly and makes it possible to reach the cervix. Next the swab is used. It looks like a little brush and might feel like a tickle or scratch. Then the swab and speculum are removed and you’ll be asked to put your clothes back on. That’s it and it shouldn’t take more than ten minutes.
What happens if I have irregular smear test results?
“It is important to say that cell changes are not cancer.” says Imogen Pinnell of Jo’s Cervical Cancer Trust. “They are cells that need monitoring, or treatment to stop them turning into cancer. This is why smear tests are so important as they can identify cells at the earliest possible stage. If you have abnormal cells detected during cervical screening then you’ll be invited to colposcopy, where a doctor will have a closer look at your cervix to work out the next step.”
A colposcopy is a procedure in which a tiny camera is used to look at the cervix for any signs of irregularity. You may also have a biopsy so that a larger sample of cells can be taken. This is similar to the swab but might feel slightly more uncomfortable and you may experience a little spotting afterwards. Of course, it’s natural to feel anxious about a colposcopy or a biopsy if you’ve never had one before, but these are routine procedures and are really essential to attend. Putting these appointments off could result in ignoring something that could easily have been treated or avoided that may become a threat to your health.
Imogen Pinnell offers the following advice to anyone who may be feeling too nervous to attend an appointment –
“The most important thing is to find out as much information as you need before you go. If you have questions then we can talk through how you’re feeling and help provide answers. Your colposcopist will also be able to help with any worries or questions you have. You might also find it helpful to read stories from others who have been for colposcopy – we have lots of these on our website.
We provide reliable information and support at every step, for anyone with questions or concerns about any aspect of cervical screening, cervical cell changes or cancer. We have a free Helpline you can call to ask questions or talk through your thoughts, an ‘Ask the Expert’ service where you can submit a medical question to one of our experts, and an online forum, where you can connect with others who are going through something similar.”
Can I get a smear test in lockdown?
Coronavirus has created additional challenges for attending a smear appointment. It can be more challenging to book, more anxiety inducing with the threat of the virus, having to wear a mask and having to attend appointments by yourself. But if you’ve received a letter inviting you to a screening, or a letter regarding your results and follow up tests, these aren’t something you can ignore. The best way to advocate for your cervical health is to get checked. If your results are clear, you won’t be invited for another test for three to five years.
It’s also worth noting that it’s not only the cervix that needs to be checked regularly. The NHS recommends staying body aware and making your GP aware of any pain or changes to your body as soon as you notice them. Breast exams and bowel exams are also available on the NHS and the service is vigilant about ensuring everyone with a cervix is made aware of the need to attend a screening and how often.
If you’re due a smear test this year or are expecting to attend your first screening and feel nervous about the experience, contact the Jo’s Cervical Cancer Trust Helpline on 0808 802 8000 or find out more at jostrust.org.uk/support.
