Also Known As
Cervical screening test
Liquid based cytology test (LBC)
Formal Name
Smear Test; PAP Test; Papanicolaou smear; Cervical/vaginal cytology
This article was last reviewed on
This article waslast modified on
18 June 2018.
At a Glance
Why Get Tested?

To screen for early abnormalities (pre-cancer) which, if left untreated, could lead to cervical cancer.

When To Get Tested?

In England, all woman between the ages of 25 and 64 are eligible for a free cervical screening test every three to five years, depending on age.
In Wales those between 20 and 64 are eligible for screening at 3 yearly intervals.
In Scotland those between 20 and 60 are eligible for screening 3 at yearly intervals.
In Northern Ireland those between 20 and 64 are eligible for screening at 5 yearly intervals.
In the Republic of Ireland those between 25 and 44 are eligible for screening at 3 yearly intervals and those between 45 and 60 at 5 yearly intervals.

Sample Required?

Cells from the cervix (neck of the womb)

Test Preparation Needed?

You may be asked to refrain from sexual intercourse for 24-48 hours before the test, avoid using vaginal creams or foams in the 48 hours before the test and book the test appointment 10-14 days after the beginning of your last menstrual period.

On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you will be able to access your results online.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, gender, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

A cervical cytology test is a test used to detect abnormal or potentially abnormal cells from the uterine cervix (neck of the womb).

How is the sample collected for testing?

The method consists of sampling cells from the cervix. A doctor or nurse inserts an instrument (a speculum) to open the woman's vagina so that they can see the cervix. The sample of cells from the surface of the cervix is obtained using a small brush. Most women consider the procedure to be only mildly uncomfortable although some have more discomfort, but it should not be painful. The specimen containing cells from the cervix is put into a special liquid preservative. This cell suspension is processed in the laboratory and the cells are transferred onto a glass slide, stained, and examined under a microscope. The fluid may also be tested for high risk human papilloma virus (HPV) types.

Is any test preparation needed to ensure the quality of the sample?

You may be asked to refrain from sexual intercourse for 24-48 hours before the test, avoid using vaginal creams or foams in the 48 hours before the test and book the test appointment 10-14 days after the beginning of your last menstrual period.

Accordion Title
Common Questions
  • How is it used?

    Your doctor or health care provider performs a cervical cytology test to look for cervical cells that are abnormal or even potentially cancerous. The cell suspension is processed in the laboratory and placed on a glass slide, stained with a special dye, and viewed under a microscope by a cytologist or pathologist. Also, the fluid is analysed for evidence of HPV infection. Abnormal cells can be present without causing any noticeable symptoms. Some women with abnormal cells require treatment whilst others may need to be monitored with repeat cervical cytology tests over a period of time as often mild changes resolve on their own.

  • When is it requested?

    In England a woman registered with a GP receives her first invitation at the age of 25. There are three-yearly examinations between 25 and 49, and five-yearly examinations between 50 and 65.

  • What does the test result mean?

    A "negative" cervical cytology test means the cells obtained appear normal. In some instances (less than 3 in 100), the sample may be reported as "inadequate" for evaluation. This generally means there are insufficient cells for reliable assessment. Other reported results are:

    • Borderline changes: Cells are present that may indicate wart virus (HPV) infection or where it is uncertain what the cells are. Most borderline changes return to normal without treatment.
    • Mild dyskaryosis: These low-grade changes are often associated with HPV and return to normal without treatment.
    • Moderate dyskaryosis: This finding indicates that abnormal cells present which may need treatment.
    • Severe dyskaryosis: This result indicates that abnormal cells are present. This indicates that high grade pre-cancer (CIN) is probably present and which is likely to require treatment.
    • Severe dyskaryosis/?Invasive carcinoma: Abnormal cells are present which indicate that high grade pre-cancer (CIN) is probably present and that cancer needs to be excluded.
    • ?Glandular neoplasia: This result means that abnormal glandular cells present. These cells may come from the cervix, the lining of the uterus (womb) or rarely from the ovary.

     

  • Is there anything else I should know?

    Cervical cytology is used as a screening test in the well-established national screening programmes. Occasionally, abnormalities may go undetected with a single test. This is why it is important to be screened regularly. The sample represents only some of cells present on the cervix. Even when carried out by a very experienced nurse or doctor, sample collection can occasionally collect too few cells to give a reliable result and a repeat cervical cytology test may be required. This happens in fewer than 3 in 100 tests.

    Cervical cytology was formerly known as the smear test. When performed routinely every 3-5 years, it is a great help in the detection and treatment of cervical abnormalities known as Cervical Intraepithelial Neoplasia (CIN). Early detection and treatment of CIN can prevent about 75% of cervical cancers developing.

    If you have any abnormal bleeding, for example, after sexual intercourse, between periods or after the menopause, it is important that you speak to your general practitioner. Your GP will be able to tell you whether you need to be referred to a gynaecologist for further investigation. Routine cervical cytology is not appropriate in these circumstances.

  • What are the risk factors for cervical cancer?

    The most important risk factor for cervical cancer is infection with some strains of the human papilloma virus (HPV, which can sometimes be called wart virus infection). High risk strains of HPV are found in 99% of cervical cancers. HPV is a very common sexually transmitted virus which most people contract shortly after becoming sexually active. In 9 out of 10 women, the virus is cleared naturally by the body’s immune system within a year.

    Vaccines are now available to help prevent infection with the most common high risk types of HPV. In the UK, HPV vaccination is offered to girls aged 12-13 years as part of a national vaccination programme. The vaccine is made available through most schools or general practitioners. It is given in three doses over a period of six months and should ideally be given before a girl becomes sexually active. Even if you have been vaccinated, it is important to continue to accept your invitation for routine screening. This is because HPV infection can occasionally occur in women who have been vaccinated.

    Some risk factors such as the age at which sexual intercourse begins (the earlier, the higher the risk) and multiple sexual partners, contribute an increased risk of having the virus. Other factors are infrequent cervical screening, a history of abnormal cervical cytology or treatment for cervical abnormalities, using the oral contraceptive pill and cigarette smoking. Women whose immune systems are less active are also at increased risk and women who are HIV positive are recommended to be screened annually.

    For most women, regular 3-5 yearly screening is enough to prevent them from developing cervical cancer by allowing abnormalities to be detected and treated early if needed. More frequent screening may be recommended for women who have had previous treatment for high-grade cervical abnormalities,

  • Does an abnormal cervical cytology test always mean cancer?

    No, a single "abnormal" test does not necessarily mean that cancer is present. The tissues of the cervix undergo constant changes and repair. Treatment of abnormalities may be carried out immediately. However, for low-grade disease, treatment may not be necessary immediately as in most cases it returns to normal without any intervention. However, the situation should be monitored closely. This may require repeat testing at regular intervals until the cells return to normal or treatment becomes necessary.

  • If I have cervical disease, what are my treatment options?

    Progression of cervical abnormalities caused by HPV infection to cervical cancer is slow, and may take many years. This is why regular cervical screening is the best way to prevent cancer from developing. Regular tests allow abnormal precancerous tissue to be found and removed. They also can detect the cancer early if it does develop allowing appropriate treatment to be given quickly.

    If an abnormal area of the cervix is found, it can be removed in an outpatients clinic using a minimally invasive surgery, also known as LLETZ. This is also the standard treatment for a very early stage cancer. In more advanced cervical cancers, a hysterectomy (removal of the womb) may need to be performed. For young women with cervical cancer, new surgical techniques are being developed that preserve fertility. In some circumstances, where the cancer is more advanced, radiotherapy or chemotherapy may be required and additional surgery may be needed.