I don’t know of any girls who haven’t groaned in the lead up to their 25th birthday “oh no… now I have to have a smear test!”. It’s not something that anybody particularly looks forward to, and research in 2011 showed that, unfortunately, a fifth of women don’t even turn up.
Now, ladies. If you’ve ever had an STI test, a smear test is nothing to fear. If you haven’t, it’s still nothing to fear. A moment of uncomfortableness for the chance to either breathe a sigh of relief or nip something nasty in the bud? I’ll take that. Around 8 women are diagnosed with cervical cancer in the UK every day, and the earlier it is found the more treatable it is.
If you’re worried about heading in to the nurse and aren’t sure what to expect, here’s what happens.
You get your letter. You make an appointment with the nurse, and you go to said appointment (that part is particularly crucial.) The nurse may ask whether you’d like to be chaperoned while the test is happening. This is nothing to worry about – if you’re comfortable with the nurse, you don’t have to, but if you’d prefer someone else to be in there then you can request it.
The nurse asks you to remove your jeans/tights/whatever and cover yourself up with a paper sheet. You’ll be behind a curtain at this point, so no need to fear the interruption of anyone rude who comes in without knocking. The nurse will ask you to lay back and scoot down the bed a little so you’re nearer to the end. You may be asked to pop your legs onto the stands so they can get a look at your goods properly – don’t worry, this makes it easier for them to do what they need to do (and therefore easier/less uncomfortable for you, too).
This is the part people are scared of: the nurse will slide a smooth, cylindrical object (no technical names here) up until the end surrounds your cervix. Try to relax when this is happening, as stiffening up will make it a bit uncomfortable for you. It might feel strange, but it’ll only be there for a few seconds. The nurse will then use a swab/stick to take a little scraping from your cervix, which sounds painful but you can hardly feel it – they’ll only be tickling a few cells off, we’re not talking a centimetre of flesh, it’s all good. The nurse will remove the cylindrical contraption, ask you to sit up, et voila: you are finished! Some people experience a little bit of bleeding so take along a liner/towel just in case. They’ll offer you one but it’ll probably be one of those huge lumpy things that shows through every item of clothing.
The results usually take around two weeks to arrive, and will hopefully say that they found no abnormal cells. If so – great! Congratulations, and breathe a sigh of relief until your next screening.
If they’ve found something, DON’T PANIC. My letter said that I had CIN2; it didn’t explain very much, I Googled and decided there and then that I definitely had cancer. It doesn’t mean that at all, and an abnormal result is actually quite common. The results are graded CIN 1, 2 or 3, and CIN stands for cervical intraepithelial neoplasia. CIN isn’t cancer: it refers to slightly abnormal cells that, if left for 10-15 years, could turn in to cancer. 1 is mild, 2 is moderate and 3 is severe. This scale is used to measure how much of the cervix is covered in these cells – CIN 1 means there are only a few abnormal cells, and CIN 3 means there is more coverage.
If your results say say you’ve got CIN 1, 2 or 3 it’s likely you’ll be invited to the outpatients centre at your local hospital for a colposcopy. This is basically the same as your smear test, except that it will be performed by a doctor and instead of scraping they’ll use a camera to take a look at the surface of your cervix. They may also perform a tiny biopsy at the same time. If you’ll be on your period on the day of your test, you’ll need to call and rearrange. The doctor will decide on the day whether your CIN requires any treatment – CIN 1 can disappear by itself. When I went for my colposcopy, they decided that I did need treatment and explained everything before they went ahead.
Firstly, you’re given a local anaesthetic, which I don’t remember feeling at all. The anaesthetic makes your heart race and your face flush for about 5 seconds, which is apparently completely normal, if not slightly weird. Once you’re numb, the doctor will effectively slice the bad cells off from the top of your cervix. THIS SOUNDS MUCH WORSE THAN IT IS. They use a sort of wire loop that quickly removes a thin layer and cauterises so that it seals, and again, I don’t remember feeling anything except a little bit of pressure. A bit like having a tooth taken out where it doesn’t hurt but you can feel something happening.
You’ll be asked to sit still for a bit to make sure you feel okay, and the doctor/nurse will advise you to take it easy for the rest of the day. I was told not to go back to work, and this turned out to be a good idea as although I felt alright when I left, I felt quite wiped out later and spent the afternoon on the sofa watching films and drinking tea.
After that, you might notice a few scabs making an appearance here and there (gross) and the doctor will tell you what to look out for in case the wound becomes infected. You’ll have another smear test in 6 months to make sure they got rid of everything that they needed to, and for the next ten years your smear tests will be every year instead of every 3-5 years.
So, that’s not so scary, is it? And remember: if your results come back positive for cervical cancer, there’s a lot of information and support available and you’re not alone. Take a look at the Macmillan Cancer site to find out more. Cervical screening is designed to catch cancer early so that there’s more chance of fighting it, but to do that you need to have your test done. So do it!
For more information about cervical screening, colposcopies, CIN treatments and cervical cancer, have a dig around on the NHS website.
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