We asked medical expert Dr. Suzanne Afsworth to prepare a detailed guide to neck screening procedures.
What is neck screening?
Cervical screening, often called smears, is a test designed to identify people at high risk for developing cervical cancer. This test involves taking small samples of cells from the cervix. The sample is then tested for the presence of high risk Human Papilloma Virus (HPV). Testing is a major part of screening tests as high-risk HPV has been shown to be responsible for more than 90% of cervical cellular changes that lead to cervical cancer. If the test is positive for the presence of HPV, the sample can be further evaluated to look for changes in the cells themselves.
Screening tests are not attempting to diagnose the cancer itself, but are done to identify early changes that may lead to cancer if left untreated. If these changes are found, they can be monitored or treated, preventing the development of cervical cancer. Smears are estimated to prevent up to 75% of all cervical cancers, but it has been suggested that if everyone attends when invited, it can prevent 83% of deaths caused by cervical cancer.
Considerations for cervical screening are sadly declining, with the lowest rate now in over 20 years. It is estimated that one in four women who were unable to attend the neck screen when invited. The pandemic has contributed to a decrease in access to smear tests, but intakes have declined well before the pandemic, and unfortunately it is clear that it has been down year-on-year during stops over the past decade. One of the biggest reasons for failing to attend is the lack of understanding and knowledge about the test itself, as well as the fear of what actually relates.
Who will be invited to the neck screening?
The NHS neck screening programme was introduced in 1988 in the UK. Under the current program, between 25 and 64 women are invited to participate in neck screenings. Women aged 25-49 are invited every three years, while those aged 50-64 are invited every five years. Screening is available to anyone of this age group who has a cervix, including trans men and non-binary people. The screening ends when someone reaches the age of 65 and recent screening test results are negative.
What happens when you take part in the test?
Cervical Screening It is generally performed at a GP surgery, sexual health clinic or specialized clinic, and is usually performed by a nurse or doctor. This test involves taking small samples of cells from the cervix using a soft brush. The brush is then placed in a special pot containing liquid and sent to the Cervical Screening Laboratory for evaluation. (In the past, samples were collected using small spatulas and cells were “filled” into slides before being sent for evaluation, where the term “smear test” comes from).
The entire booking can last about 20 minutes, but the actual test itself only takes 2-3 minutes to run. A doctor or nurse will explain the test to you and then give you some privacy to prepare yourself. This involves taking off her waist, taking off her clothes and lying on the exam sofa. A clean sheet of paper is given to cover the lower half. In normal position, you will need to lie down with your knees bent and knees.
The first part of the test involves using Speculum. This is a cylinder-shaped device that is gently inserted into the vagina and opens to view the cervix. Next, gently rotate a small soft brush from the surface of the cervix to pick up many cells. The cells picked up with the brush are then placed in a special pot containing the liquid, allowing them to be safely transported to the lab for testing. The mirror is then gently removed and you can wear clothes again. The test is over!
For most women, this test is completely painless. Sometimes, some women can find the use of the mirror uncomfortable. This is more common when you are very worried about the test or experience other problems, such as vaginal dryness as a result of menopause. In this case, talking to a doctor or nurse about this before an appointment often means that you can do things to make your tests more comfortable.
What happens after the test?
After testing, samples will be sent to the Cervical Screening Laboratory for further evaluation and will receive results by post. In England, Scotland and Wales, samples were first tested for the presence of high-risk human papilloma virus. This is known as HPV primary screening.
If the sample test is negative for the presence of HPV, it means that you are very unlikely to develop cellular changes that can lead to cervical cancer. Therefore, no further tests are performed in the sample. Simply receive a letter indicating that the test is negative and will be invited back to the smear for another year or so, depending on your age.
If the sample test is positive for the presence of HPV, further evaluation of the specimen is performed. Cells collected during the test are looked at under a microscope to see if changes have begun to occur. If the cells appear normal, they will be invited to repeat screening tests one year later. If cell changes are found, you may be invited to receive a more detailed assessment at the Colposcopy Clinic. This is where the cervix is examined more closely by camera.
Frequent examinations and doctor appointments can help prevent health problems or recognize risks early and start treatment as soon as possible. In most cases, it’s enough to be checked once a year, so you can plan and not take too long, but it helps you stay healthy.
