What do the different smear tests results mean?
A smear test or cervical screening is a test done to check the health of the cervix. All those with a cervix, aged 25-64 will be invited to a screening at least every three or five years, depending on where you live and your age.
During the test a small sample of the cells from your cervix will be collected and sent to a lab for testing. If you live in England, Scotland or Wales you will have HPV primary screening, which means the sample will be tested for the presence of human papillomavirus (HPV), a virus that is linked to cervical cancer. If you live in Northern Ireland cytology is used, to test the sample for changes to the cells. If changes to the cells are detected then the sample is tested for HPV. Find out more about what to expect during a smear test.
HPV
HPV is a very common virus that up to 8 out of 10 of us will have at some point in our lives. Typically it infects the skin and moist membranes (such as the cervix, vagina or lining of the mouth and throat). In most cases this infection will be fought off by the body in two years and is symptomless. However, depending on the strain, HPV may lead to genital warts, lay dormant or in some cases encourage uncontrolled growth of the infected cells which may result in cancer.
There are over 100 strains of the virus, but only certain types would increase the chances of developing cervical cancer. The high risk strains for cervical cancer include 16, 18, 31, 33 and 45. At least one of these HPV types is present in the vast majority of women with cervical cancer. Types 16 and 18 cause around 70% of cervical cancers, while the other three account for most of the remaining 30%.
The HPV vaccine is an effective way to protect you against high risk strains of HPV and was first licensed in 2006. The vaccine is offered to boys and girls aged 12-13 as part of the National Immunisation Programme. It is also offered on the NHS to females who didn’t receive the vaccination whilst at school and are under 25, as well as men under 45 who have sex with men. You can also access the vaccine privately, through our HPV clinic.
Smear tests are an effective way of detecting HPV infection. Catching and treating the infection early will reduce the chances of it developing into cervical cancer.
HPV primary screening results
This type of screening tests the sample from the cervix for the HPV virus. If the HPV virus is present, the lab will then look to see if you have any of the high risk strains of HPV. As mentioned, high risk strains of HPV can cause cells to change, which in some cases can lead to cancer.
The results of this type of screening fall into three categories – no HPV found, HPV found with no cell changes and HPV found with cell changes.
No HPV found
If you get this result it means that you don’t have high risk HPV and you will be invited to another screening in three or five years depending on your age or where you live.
HPV found with no cell changes
This result means high risk strains of HPV have been found in your sample, but there are no changes to the cells collected. You will be invited back for another screening in a year.
HPV found with cell changes
This result means high risk HPV strains have been found in your sample and cell changes were also detected. After this result you will be invited for a colposcopy for further testing. Find out more about colposcopies.
Cervical screening cytology results
These tests will test for changes in cervical cells first and then if changes are found they are tested for HPV. The results will be either normal or abnormal.
Normal
This result means that no cell changes were found in your sample. In this instance you will be invited back for another screening in three to five years depending on your age.
Abnormal
This result would mean cell changes were found and these are categorised as borderline, low grade or high grade changes.
If high grade cell changes are detected you will be invited for a colposcopy. You will also be invited for a colposcopy if you have borderline to low grade changes where HPV is present. If you have borderline to low grade changes and no HPV is present you will be invited back for another screening in three to five years.
Inconclusive results
In some cases you’ll be invited back for a test in three months. This is usually because the results were unclear, for example because there were not enough cells in the sample, rather than there being something wrong.
Resources
https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/
https://www.jostrust.org.uk/information/hpv/what-is-hpv
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/risk-factors#heading-Two
