Cervical Screening – by Georgia Pattison

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People ignore their cervical screening letter invitation for many reasons; a worry of how long the screening may take, a fear of judgement from the nurse doing the screening, but for many it can be the fear of the unknown. We know that Lesbian and Bisexual Women in particular are up to 10 times less likely to have had a cervical screening test in the past 3 years than heterosexual women. This of course puts this group of women in a higher risk categories for certain types of HPV-Due to not getting their screening done.

I want to ease any worries that you may have around screening with this blog and hopefully encourage more people with a cervix to have their cervical screening.

What is Cervical Screening?

A cervical screening (also known as a smear test) is a free health test available through the NHS as part of the National Cervical Screening Programme. During the test, a nurse takes a sample of cells from the cervix using a small, soft brush. This is sent to the lab to test for high risk human papillomavirus (HPV) and any cervical cell changes. A cervical screening is not a test for cancer.

What is Human Papillomavirus (HPV)?

Human Papillomavirus is the name of a common virus that can infect the skin and any moist membrane such as the cervix, lining of the mouth and throat, the vagina, vulva and anus. Around 8 in 10 men and women will get HPV at some point in their lives but in most cases the immune system will get rid of it without causing any problems. HPV is usually spread through skin to skin contact which could include vaginal, oral and anal sex. Although rarer, HPV can also be passed on through sharing sex toys and touching in the genital area.

Who should have a Cervical Screening?

Anyone who has a cervix should have a cervical screening. However, you may not receive an automatic invitation from the screening programme if you are transgender or non-binary and registered as male with your GP but have a cervix. In the UK you will be automatically invited by your GP for cervical screening if you are registered as female with your GP and you are between the ages of 25-64.

How often should you have a Cervical Screening?

People aged 25 to 49 should have a screening every 3 years. People aged between 50 to 64 should have a cervical screening every 5 years. Screening stops at the age of 64 as it is highly unlikely that people over the age of 64 who have been regularly screened will go on to develop the disease. This is because it is estimated that it takes between 10 and 20 years for HPV infection to develop into abnormal cervical cells. However, any person aged over 64 who has never had a screening or hasn’t had one since they were 50 are entitled to be screened.

What will happen during your Cervical Screening Appointment?

Your whole appointment should last between 10-15 minutes including discussion with the nurse taking your sample. The discussion should include the nurse explaining the process of a cervical screening. If you are comfortable to do so, you may want to discuss speculum sizes with the nurse. A speculum is the plastic (sometimes metal) cylinder that is placed into the vagina. There are different size speculums available. Some sizes may not be suitable if you have not had penetrative vaginal sex before but the nurse will be able to discuss this with you. Smaller speculum sizes may also be used for anyone with vaginismus or anyone who has experienced sexual/physical based trauma. Vaginismus is a condition where the vaginal muscles tighten up on their own if penetration is attempted. Vaginismus can be distressing, but it can be treated.

When you are ready, the nurse will gently insert a new, clean speculum into your vagina. A small amount of water-based lube may be used to make it more comfortable. The speculum is sometimes the part that people may find uncomfortable but always remember that you are in control of the screening and can ask the nurse to stop at any time.

Once the speculum is inside the vagina, it will slowly be opened so that the nurse can see your cervix. Using a small, soft brush the nurse will take a small sample of cells from your cervix. The cell samples will then be put into a plastic container (vial) in order to preserve the cells so they can be sent to a lab for testing. The nurse will then gently close and remove the speculum and give you a private space to get dressed again. When you are ready, the nurse will explain how and when you should get your results.

What happens after your cervical screening appointment?

After the appointment, most people can continue as normal. Some may have some light bleeding (spotting) for a day after. Your cervical screening results should arrive by post within 2 weeks.

If you do have any more questions about cervical screening or you wish to have further support, you can contact the sexual health team on 0121 643 0821 or email sexualhealth@blgbt.org with your enquiry. Alternatively, we also have a Lesbian and Bisexual Women’s Worker and Trans Sexual Health Outreach Worker who are both able to work on a 1-1 basis with you to discuss any concerns you may have around screening.

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