A smear test from 25 to 64. The interval lengthened because the test improved — and that alarmed a lot of people unnecessarily.
NHS screening is free — this page explains it, we do not sell it
Honest about who benefits and who may be harmed
A GP to talk through a result, a recall or a missed invitation
Your NHS records in the room, with your consent
Talk it through with a GP
Screening itself is free on the NHS. If you want a result explained, have been recalled, or missed an invitation and are not sure what to do, a 20-minute appointment with a GMC-registered GP is £40. Same-day appointments are usually available, 6am to 10pm, seven days a week.
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Anyone with a cervix aged 25 to 64 is invited, whether or not they are sexually active now, whether or not they have had the HPV vaccine, and whatever their sexual orientation.
The gap between tests has lengthened to five years for most people who test HPV negative. That change caused a good deal of alarm, and the alarm was misplaced.
It happened because the test got better. Screening now looks for high-risk HPV first, and HPV testing is considerably more sensitive than the old cell examination. If you have no high-risk HPV, your chance of developing significant cervical changes in the next five years is very low — lower than it was over three years under the old test.
Anyone who tests HPV positive is seen sooner, usually at 12 months. The interval is now set by your result rather than by the calendar, which is a better system, not a cheaper one.
If you have a cervix and are registered as male with your GP, you will not be invited. The system generates invitations from registered gender, and this is a well-recognised gap.
You remain at risk and remain entitled to screening. Ask your GP practice to arrange it, and say if you would prefer a particular clinician or a longer appointment.
It depends on whether the cervix was removed. A total hysterectomy usually ends screening; a subtotal one does not. Some women need vault smears afterwards.
Check rather than assume — people are wrongly removed from the register both ways.
Usually five to ten minutes with a practice nurse.
It should not be painful. Uncomfortable is normal; painful is not, and is a reason to say something rather than endure it.
The sample is tested for high-risk HPV first. Only if HPV is found are the cells then examined.
"HPV positive, no abnormal cells" is the result that frightens people most and needs least action. It means a very common virus was detected and your cells look entirely normal.
A closer look at the cervix with a magnifying instrument, taking about fifteen minutes, with no anaesthetic needed. A small biopsy may be taken.
Abnormal cells found at colposcopy are pre-cancerous, not cancer, and removing them is straightforward and highly effective.
Cervical cancer is one of the few cancers that is very largely preventable, and the UK has the two tools that prevent it: the HPV vaccine and this programme.
NHS England has set out an ambition to eliminate cervical cancer as a public health problem by 2040, through vaccination and screening together. That is a realistic target and it depends on people attending.
The majority of cases occur in people who have never been screened, or whose screening lapsed. That is the single most important fact about this programme.
The interval change was recommended by the UK National Screening Committee on the basis of that evidence, not on cost grounds — a distinction worth making, because it was widely reported as a reduction in service.
Reviewed against UK National Screening Committee, NHS Cervical Screening Programme and NICE guidance current at the date shown above.
Around seven in ten eligible people attend, and the figure has been falling — particularly among those in their twenties and thirties.
Tell the person taking the sample, or write it down if saying it is hard. They can slow down, explain each step, stop when you ask, and give you control of the pace.
You are not the first person to raise it, and specialist support is available through your GP or a sexual assault referral centre.
HPV self-sampling kits are being introduced for people who do not attend, allowing a sample to be taken at home. Availability is expanding — worth asking your practice whether it is offered in your area.
Screening is for people without symptoms. If you have any of the following, you need assessment now, whatever your last result was:
A normal smear does not exclude cervical cancer if you have symptoms. This is one of the most consequential misunderstandings in the whole of screening, and it delays diagnoses every year.
It screens the cervix and nothing else. It does not detect ovarian, womb, vaginal or vulval cancer, and it is not a general gynaecological check.
For cervical screening the balance is clearly favourable — more so than for breast screening — because the programme prevents cancers rather than only finding them earlier, and because the treatment for pre-cancerous change is minor.
If you had the HPV vaccine, you still need screening. It protects against the types causing most cervical cancer, but not all of them, and this misunderstanding is now a genuine risk as vaccinated cohorts reach screening age.
Because the test improved. Screening now looks for high-risk HPV first, which is considerably more sensitive than the old cell examination.
If you have no high-risk HPV, your risk over the next five years is very low — lower than it was over three years under the old test. Anyone who tests positive is seen sooner.
A very common virus was found and your cells look completely normal. You will be invited back in 12 months, and most people clear it by then.
It says nothing about when you caught it or from whom — HPV can lie dormant for years.
Yes. The vaccine covers the most dangerous types but not every one.
Skipping screening because you were vaccinated is a real and growing risk as vaccinated age groups reach 25.
It should not. Uncomfortable is normal; painful is not.
Ask for a smaller speculum, a longer appointment, or to insert it yourself. If you are past the menopause and it has hurt before, ask about a few weeks of vaginal oestrogen first — it makes a substantial difference and is rarely offered.
If you have ever been sexually active, yes. HPV can persist for many years after exposure.
If you have never had any sexual contact of any kind, your risk is very low and it is reasonable to discuss opting out — but that is a conversation, not an assumption.
Yes. HPV is passed through skin-to-skin genital contact, including between women.
Women who have sex with women attend less often and are at no less risk, which is a well-documented and avoidable gap.
No, and nobody will make you feel bad about it. Ring and book.
The majority of cervical cancers occur in people who were never screened or stopped attending — which makes going now the single most useful thing you can do.
Tell them, or write it down beforehand. The appointment can be slowed down, paused, or stopped entirely, and you can bring someone with you.
You are far from the first person to raise this, and self-sampling may become an option where it is available.
Not if you are registered as male — the system generates invitations from registered gender.
You remain eligible and at risk. Ask your practice to arrange it, and to note any preferences about how.
No. Get assessed now. Screening is for people without symptoms and does not rule out cancer in someone who has them.
Treating a clear smear as reassurance in the face of symptoms is one of the commonest causes of delayed diagnosis.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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