Cancer
Smear test: Everything you need to know before your appointment
Article produced in association with Spital Clinic
Cervical screening saves thousands of lives from cervical cancer in the UK every year.
The programme has changed significantly in recent years, and understanding what it now involves — and what your results actually mean — is probably the most useful preparation you can do before your appointment.
Why Cervical Screening Exists — and What Changed in 2025
The NHS cervical screening programme now uses HPV primary screening — a method NHS England describes as testing for the human papillomavirus (HPV) rather than looking directly for abnormal cells.
If HPV is not found, the sample is not examined further; if HPV is found, the same sample is then checked for cell changes.
The reason HPV sits at the centre of this approach is straightforward. Nearly all cervical cancers are caused by certain high-risk types of HPV — and HPV is extremely common.
Most people encounter some form of it during their lives, and the body usually clears it without any treatment.
The problem arises when high-risk HPV persists, because over time it can cause cell changes in the cervix that, if left undetected, may eventually develop into cancer.
Cervical screening is therefore a prevention test, not a cancer diagnosis. Its purpose is to find those cell changes early, when treatment is straightforward and effective.
A significant change took effect in England on 1 July 2025.
The screening interval for those aged 25–49 was extended from three years to five years, in line with the 50–64 age group — so everyone aged 25 to 64 in England is now invited every five years.
The interval in Northern Ireland currently differs; Cancer Research UK has current details.
Who Is Invited and How to Book
NHS England invites everyone with a cervix aged 25 to 64, with the first letter usually arriving a few months before a person’s 25th birthday.
Invitations are sent automatically and are linked to GP registration — the simplest way to make sure yours arrives is to be registered with a GP and keep your contact details up to date. If your invitation hasn’t come through, any GP surgery can arrange an appointment.
Trans men and non-binary people registered as female with their GP will receive invitations automatically.
Those registered as male will not — but can self-refer through the NHS cervical screening programme website or ask their GP to arrange a test.
People over 65 are not routinely invited but are not excluded.
Anyone who has never been screened, or whose most recent result was abnormal, can request screening through their GP or a clinic.
Appointments are most commonly offered at GP surgeries, carried out by a nurse or doctor.
For those who prefer a different setting, shorter waits, or an appointment outside NHS hours, a private smear test can be arranged through specialist gynaecology clinics, often within a few days.
What Happens at a Smear Test Appointment
The test itself takes less than five minutes, with the full appointment lasting around ten minutes.
Knowing what happens — step by step — removes most of the uncertainty that makes it feel more daunting than it actually is.
You undress from the waist down and lie on an examination table, knees bent and falling gently apart.
The nurse or doctor applies a little lubricant and gently inserts a small speculum, which is opened just enough to make the cervix visible.
A small, soft brush sweeps a cell sample from the surface of the cervix. The speculum is removed, and you get dressed.
That is the entirety of the test.
A little preparation helps both comfort and sample quality.
Avoid vaginal medicines, lubricants, and creams for at least two days beforehand, as residue can interfere with the results. Avoid scheduling during your period for the same reason.
Loose-fitting clothing — a skirt or wide-leg trousers — makes undressing and repositioning much easier.
If you are going through the menopause, vaginal dryness can make speculum insertion uncomfortable.
Cancer Research UK notes that using a short course of oestrogen cream or pessaries for around two weeks beforehand can help considerably — though stop two days before the appointment to avoid affecting the sample.
It is worth mentioning to your GP when you book.
Most people feel some pressure or mild discomfort, but it does not usually hurt.
If you find it painful, you can ask for a smaller speculum, insert it yourself, or try lying on your side — all are standard adjustments. Light spotting afterwards is normal and usually clears within a few hours. You can ask to stop at any point.
Understanding Your Results
The most common result — received by 87 in every 100 people screened — is HPV not found.
That means no high-risk HPV was detected, your risk of developing cervical cancer before the next screen is very low, and nothing further is needed until your next invitation arrives in five years.
The other results fall into two categories. Nine in every 100 people are told HPV was found, but no cell changes were detected.
This is not a cancer result and does not require immediate treatment — it means high-risk HPV is present and the cervix is being monitored.
The pathway is a repeat screen at one year; if HPV is still present, another repeat at two years. Only if it persists at that point is a colposcopy referral made.
Four in every 100 people receive an HPV-positive result alongside detected cell changes, and are referred directly for colposcopy.
That referral is not a diagnosis of cancer.
A colposcopy is a closer examination of the cervix, carried out in a clinic using a magnifying device, allowing a clinician to look in detail at any flagged cell changes.
Most people who attend colposcopy do not have cervical cancer — NHS England is clear on this. If a biopsy is taken or cells are removed, there is a small risk of bleeding and infection, both well-managed.
Those who prefer not to wait for an NHS appointment can access a private colposcopy at specialist clinics.
Results usually arrive by post or through the NHS App within two to six weeks. Samples are kept for ten years.
HPV can remain in the body for many years without symptoms, so a positive result says nothing about recent exposure or transmission history.
HPV, the Vaccine, and When to See a GP Without Waiting
Nearly all cases of cervical cancer are linked to high-risk HPV.
The virus spreads through skin-to-skin genital contact, vaginal, anal or oral sex, and sharing sex toys — it does not require penetrative sex to pass between people. The vast majority of people who carry it clear it naturally and will never know they had it.
The UK’s HPV vaccination programme, which began in 2008, has meaningfully reduced risk in younger age groups.
But vaccinated people still need to attend cervical screening — the vaccine does not protect against all high-risk HPV types. Vaccination and screening work together; one does not replace the other.
Cervical screening runs on a schedule, but some symptoms need attention straight away — do not wait for your routine invitation.
According to NHS England, these include unusual vaginal bleeding, bleeding after sex, bleeding during or after the menopause, heavier periods than usual, changes in vaginal discharge, pain during sex, or persistent lower back or pelvic pain.
These symptoms do not confirm anything, but they need investigating without delay.
Attending every invitation remains the single most important thing anyone in the eligible age group can do — and with the 2025 extension to five-year intervals, each appointment now covers a longer window than it once did.
The extension of the English screening interval to five years is backed by strong evidence about the accuracy of HPV primary screening.
Simply turning up remains, by some margin, the most protective thing anyone in the eligible age group can do.
This article is for informational purposes only and does not constitute medical advice. For personal health concerns, consult a qualified healthcare professional. Cervical screening eligibility and intervals may vary; refer to current NHS guidance or your GP for the most up-to-date information applicable to your circumstances. This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.
Only one per cent of women can name all five gynaecological cancers, new research suggests, as 21 women in the UK die every day of the diseases.
The report also found that 31 per cent of women have put off or avoided seeking medical advice for gynaecological symptoms.
It also found that 43 per cent of women invited for cervical screening said barriers had put them off attending, while 18 per cent of respondents aged 25 to 34 who had been invited had never attended.
The five main gynaecological cancers are womb, also called uterine, ovarian, cervical, vulval and vaginal cancer.
The Lady Garden Foundation said that, while progress has been made since the UK government’s 2022 Women’s Health Strategy aimed to improve gynaecological cancer care, significant challenges remain.
John Butler, medical director and trustee at the Lady Garden Foundation, said: “The fact that only one per cent of the population can name the diseases that directly affect half of us underscores a significant awareness gap, impacting individuals’ ability to recognise vital signs and symptoms or seek timely medical help.
“Addressing this isn’t just about awareness; it’s a critical public health priority. Our collective efforts are essential to ensure the latest commitments announced by this government translate into tangible change that saves lives.”
The report said key reasons for delaying medical advice included difficulty making appointments, embarrassment and, for cervical screening, fear of pain or previous bad experiences.
Women also reported challenges within healthcare interactions, including feeling “not taken seriously”, “dismissed” or “not believed” when seeking gynaecological advice.
Jenny Halpern Prince, chief executive and charity co-founder, said: “We frequently hear reports of women feeling ‘not taken seriously,’ ‘dismissed,’ or ‘not believed’ when seeking gynaecological advice.
“These experiences highlight crucial areas where we can improve patient support and trust within our healthcare system, ensuring women receive the empathetic and effective care they need.”
The Lady Garden Foundation said it aims to increase awareness of both the charity and the five gynaecological cancers.
It also aims to serve as a primary entry point for reliable, stigma-free information, helping people understand their bodies, recognise symptoms and overcome barriers to accessing care.
Its Silent No More Garden was unveiled at the RHS Chelsea Flower Show 2026. Designed by Darren Hawkes, the garden serves as a national call to action, using five sculptures to spark conversations, break long-standing taboos and encourage open dialogue about symptoms and preventative care.
Butler said: “Continued focus and collaborative action are essential to progress.
“The ongoing commitment from the government, alongside societal efforts to break down taboos surrounding gynaecological health, are crucial.
“The Lady Garden Foundation is dedicated to being a beacon of information and support, empowering women with the knowledge they need. We urge everyone to learn the signs, speak up, and help us save lives.”
AI could transform ovarian care by personalising cancer and fertility treatment, but more clinical validation is needed before routine use.
A systematic review and meta-analysis found AI models showed high diagnostic accuracy for ovarian cancer when combining data such as ultrasound scans and blood test results.
Across 81 studies, AI models correctly identified ovarian cancer in around nine out of 10 cases, with pooled rates of 89 to 94 per cent.
They were also highly accurate at ruling out ovarian cancer when it was not present, with specificity of 85 to 91 per cent.
The analysis also found that explainable AI tools could predict complete surgical cytoreduction in advanced ovarian cancer.
Complete surgical cytoreduction means removing all visible cancer during surgery, which can be an important goal in treatment planning.
The tools achieved a pooled AUC of 0.87. AUC is a measure of how well a model distinguishes between different outcomes, with higher scores showing stronger performance.
In reproductive medicine, AI algorithms helped physicians optimise ovarian stimulation protocols and predict follicular growth during IVF.
Ovarian stimulation is the use of hormones to encourage the ovaries to produce eggs, while follicles are the small sacs in the ovaries where eggs develop.
The review found AI could reliably model ovarian response in IVF with a pooled AUC of 0.81.
However, researchers said challenges remain in translating promising research findings into routine clinical practice.
They identified substantial variation across studies, driven by retrospective study designs, variable AI systems and a lack of standardised validation.
Only 22 per cent of analysed studies reported prospective, multicentre external validation, where models are tested forward in time across multiple healthcare settings.
The authors called for rigorous validation to help close the gap between research and routine clinical practice, alongside standardised methodological and reporting frameworks, smooth integration with clinical workflow and robust governance to support responsible and ethical AI use.
They concluded: “Artificial intelligence is a transformative force in the management of ovarian conditions.
“In gynaecologic oncology, AI enhances every phase of care, from early detection and accurate diagnosis to prognostic stratification and surgical planning.”
In reproductive medicine, AI personalises ovarian stimulation and refines the diagnosis of heterogenous endocrine disorders such as PCOS.
PCOS, or polycystic ovary syndrome, is a hormonal condition that can affect periods, skin, weight and fertility.
Femtech World is delighted to reveal the shortlist for this year’s Women’s Cancer Innovation award.
The award, sponsored by Endomag, will honour a groundbreaking innovation dedicated to the prevention, early detection treatment or ongoing care of cancers that uniquely or disproportionately affect women.
Endomag is a medical technology company devoted to improving the global standard of cancer care.
Its Sentimag system, Magseed marker and Magtrace lymphatic tracer are used by thousands of the world’s leading physicians and cancer centres.
After careful review of this year’s submissions, we are delighted to announce the three shortlisted entries for the Women’s Cancer Innovation Award 2026.
Auria is tackling one of the most stubborn problems in breast cancer screening: the 66 per cent of women who simply don’t participate.
Rather than improving existing imaging pathways, Auria is creating an entirely new access layer: a non-invasive, at-home test that detects protein biomarkers for breast cancer in tears.
Auria’s test, a CLIA-certified Lab Developed Test, has been validated across more than 2,000 patients in multiple clinical studies with collaborators including MD Anderson Cancer Center and Stanford University.
It reports a sensitivity of 93 per cent and a negative predictive value of 98 per cent.
Founded on six years of combined research at the University of Barcelona and UC Irvine, The Blue Box has developed a non-invasive, urine-based test that detects breast cancer by analysing volatile organic compound (VOC) signatures – no radiation, no compression, no imaging facility required.
The test achieves a sensitivity of 88.42 per cent, outperforming mammography by 15 per cent overall, and by 30 per cent specifically in women with dense breasts.
The technology could function as a first-line screening tool in primary care settings, as a complement to mammography for high-density patients, or as an accessible alternative in healthcare systems where imaging infrastructure is limited.
Celbrea is a disposable and affordable thermal screening device that empowers women of all ages to stay on top of monitoring their breast health.
The device aims to add to doctors’ existing standard evaluation protocols with a quick, painless examination. Celbrea does not replace a mammogram but simply provides an additional way to screen for breast disease, including breast cancer.
The device consisting of two disposable pads with photochromic sensors. The pads are self-applied to each breast for 15 minutes.
1188 nano-sensors are embedded within a biocompatible multilayer pad, accurately measuring any temperature differences on the surface of the breast using liquid crystal thermographic technology.
What happens next
The shortlisted entries will now be judge by an Endomag representative who will reveal the winner at a virtual awards event on June 19.
Winners will receive a trophy and will be interviewed by a Femtech World journalist.
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