NHS Cervical Screening Programme FAQs
NHS Cervical Screening Programme FAQs |
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Frequently Asked Questions
I'm trying to get pregnant - should I have cervical screening?We don't normally recommend that a woman should have cervical screening when she is (or might be) pregnant, but this would depend in an individual case on her previous history. If you've had abnormal smears in the past, for example, or if you haven't accepted your past invitations for screening, then you should consult your doctor or practice nurse to ask for advice. I have always attended for cervical screening and have never had an abnormal result. Now I'm pregnant, should I accept my invitation?If you have a normal smear history then it's better to wait until about three months after the delivery before you go for cervical screening. When is the best time in the menstrual cycle to have cervical screening?Mid -cycle (usually 14 days after your last period) is the best time because a clearer background to the sample can be gained around this time. This is because the mucus plug is at its thinnest so the sample is less likely to be masked or contain mucus. Also, the epithelium (lining) is at its thickest so the sample taken contains a full range of cells. But it's not a strict rule, so do take advice from your doctor or practice nurse if you can't make an appointment at that time. Will cervical screening pick up any other infections?It might, but that's not really the aim of the programme which is to detect and treat early abnormalities which, if left untreated, could lead to cervical cancer. Incidental findings of infections are not part of the NHS Cervical Screening Programme but may be reported and acted upon according to local protocols. I've had a hysterectomy - do I still need cervical screening?The sort of smears which are sometimes taken after hysterectomy are not the routine tests that women have in the NHS Cervical Screening Programme, but are vault smears. They are part of surgical follow-up and depend upon the reason for the hysterectomy, what was found at the time, and whether or not the abnormal cells were completely removed. The surgical team who performed the operation will decide what kind of follow-up is appropriate and you should talk it over with them. Normally speaking, if you do not have a cervix, then you do not need cervical screening. My cervical screening test showed borderline changes. Why do I have to wait six months for a repeat test-won't they get worse?The reason we repeat the test in six months is to give minor changes a chance to get better without any treatment which is what usually happens. If the repeat test is normal, you will be asked to have one more test in six to twelve months' time to check that the cells are still healthy. You can then go back to receiving routine invitations as before. If your repeat test still shows borderline changes (also called mild dyskaryosis), you may be referred for a colposcopy. I'm on the pill. Does this increase my risk of cervical cancer?Evidence suggests that long-term use of combined oral contraceptives or progestogen-only injectable contraceptives is associated with a small increased risk of cervical cancer. The level of risk returns to that for never-users within 10 years of stopping use. Oral contraceptives and cervical cancer [PDF 239Kb]. Why isn't cervical screening offered to women who are under 25?This is because changes in the young cervix are normal. If they were thought to be abnormal this could lead to unnecessary treatment which could have consequences for women's childbearing. Any abnormal changes can be easily picked up and treated from the age of 25. Rarely, younger women experience symptoms such as unexpected bleeding or bleeding after intercourse. If this happens to you, then please see your GP for advice. I'm not sexually active - do I still need cervical screening?The evidence shows that if a woman has never been sexually active with a man then her risk of developing cervical cancer is very low indeed. We don't say 'no risk' just 'low risk'. A woman who has ever had sex with a man will probably have come into contact with HPV which causes cervical cancer so she should accept her invitation for cervical screening. I am a carer, looking after someone who lacks the mental capacity to make their own decisions about screening. They have been invited for screening. How should I deal with their invitation?If the person you care for is unable to make their own decisions about screening, then you, as their carer, should make what is called a 'best interests' decision on their behalf, in the same way as you may be making other decisions about their care and treatment. You will need to weigh up the benefits of screening, the possible harm to them and what you think the person would have wanted to do themselves. Whether you are a paid carer, or an unpaid carer, family member or close friend, the process is the same. Some people may have fluctuating mental capacity, in which case, the decision about screening should be delayed until the individual is able to decide for themselves. If you do need to make a decision on someone else's behalf, you will need to consider what is involved in the screening process (including any further diagnostic tests that may be needed if the person receives an abnormal screening result). You may find it helpful to speak to their GP to discuss, for example, the person's risk of developing the cancer in question and how screening may affect them. You must also consider what you think the person themselves would want. For example, did they used to go to screening, or express an opinion about it? Did they express more general views about their health and whether they would want to know if they had a disease or condition? Or did they refuse screening in the past? Paid carers in particular should get advice from family members or friends about the person's views. If, after all this, you consider that screening is in the best interests of the person you care for, then you are within your rights to help that person to be screened. You should feel confident that if someone asks you, you will be able to explain the reasons for the best interests decision that you have made - either for, or against, screening. To find out more about the cervical screening process, please read our leaflets Cervical screening - the facts, What your abnormal result means, and The colposcopy examination [PDF 164Kb]. Additional information can be found in the Cancerbackup booklet Understanding cervical screening. To help someone with limited capacity to understand the screening process, you may find the picture leaflet An easy guide to cervical screening helpful. To find out more on making a best interests decision, you can read Making decisions: A guide for family, friends and other unpaid carers [PDF 390Kb] from the Office of the Public Guardian. There is also Making decisions: A guide for people who work in health and social care [PDF 320Kb] on making best interests decisions. To find out more about consenting to screening, please read our Consent to cancer screening guidance. To find out more general information regarding consent and access to screening, please refer to our guidance Equal access to breast and cervical screening for disabled women. I am in a same sex relationship. Do I need cervical screening?The Human Papilloma Virus ( HPV) which causes cervical cancer can be transmitted between women. Even women who have never had sex with a man can't be said to be at no risk of contracting the virus, only at low risk. Therefore it is still advisable to be screened. Do I have to go to my GP practice for cervical screening?No, you can have cervical screening at a well woman or family planning clinic. Or you could go to the genito-urinary medicine (GUM) department of a hospital. You will find details of all of these in your local telephone directory. Will treatment for cervical abnormalities affect my future childbearing?There is evidence to show that some kinds of treatment can lead to premature delivery and/or low birth weight. You might like to discuss this with the doctor at the colposcopy clinic. |
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