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Cervical Screening

Cervical screening, sometimes called a smear test, is not a test for cancer. It checks for high-risk HPV, and if HPV is found, it checks your cells for changes. This means problems can be found and treated years before they could become cancer.

Who is eligible

In England, everyone with a cervix aged 25 to 64 who is registered with a GP is invited for screening. Invitations arrive through the NHS App, by text or by letter.

Under 25Not invited. Cell changes are common and usually clear up on their own at this age
Age 25First invitation, sent a few months before your 25th birthday
Age 25 to 49Every 5 years if no HPV is found (this changed from every 3 years in July 2025)
Age 50 to 64Every 5 years
Age 65+Only invited if a recent test found HPV or cell changes. If you've never been screened, or not since age 50, you can ask your GP for a test
  • Trans men and non-binary people with a cervix should be screened. If you're registered with your GP as male or another sex, you may not be invited automatically. Ask your GP surgery, a sexual health service or your gender clinic to arrange invitations, or ask to be booked in every 5 years (or sooner if HPV is found). Screening also applies to intersex people with a cervix.
  • Trans women and non-binary people without a cervix don't need screening. If you're invited, you can ask to be removed from the list.
  • If you've had a total hysterectomy (womb and cervix removed), you don't need screening. Check with your GP if you're not sure which type you had.
  • If you're pregnant, you're usually advised to wait until around 12 weeks after giving birth. Speak to your midwife or GP.
  • If you're not registered with a GP, register with one so you can be invited. Sexual health clinics may also offer screening.
  • Whoever your partners are and however many you've had, if you've ever had any sexual contact you can have HPV, so screening is recommended.

The move to 5 years is based on strong evidence. A study of 1.3 million women in England found that serious cell changes (CIN3 or worse) were found in 1.21 per 1,000 people screened three years after a negative HPV test, compared with 4.52 per 1,000 after a negative smear test under the old system. A negative HPV test gives much longer protection (Rebolj et al., 2022).

Cervical screening is for people without symptoms. If you have unusual bleeding, discharge or pain, don't wait for or book a routine screening test. See your GP or a sexual health clinic instead.

Scotland and Wales also screen every 5 years after a negative HPV test. In Northern Ireland, people aged 25 to 49 are currently invited every 3 years, and people aged 50 to 64 every 5 years. If you've missed your test, you don't need to wait for a new letter. Contact your GP surgery to book.

What happens at the appointment

Cervical screening is usually done by a nurse at your GP surgery or a sexual health clinic. The appointment takes about 10 minutes, and taking the sample takes only a minute or two.

  • You undress from the waist down behind a screen, and lie on a bed with a paper sheet over you.
  • The nurse gently puts a smooth, tube-shaped tool called a speculum into your vagina so they can see your cervix.
  • They use a small, soft brush to take a sample of cells from your cervix.
  • The speculum is removed and you can get dressed. Your results are usually sent to you by letter.
Front view of the female reproductive system labelled with the fallopian tubes, ovaries, womb (uterus), cervix (the neck of the womb), transformation zone and vagina. The transformation zone, at the opening of the cervix, is highlighted as where most cervical cancers start and where the screening sample is taken from.

Barriers to screening and what can help

Nearly a third of eligible people in England aren't up to date with screening. These are some of the most common reasons, and what can make it easier.

Embarrassment or body worriesNurses do these tests every day. You can wear a skirt or dress so you stay partly covered, and you can ask for a female nurse.
Worry that it will hurtAsk for a smaller speculum, or to put the speculum in yourself. Tell the nurse if you're uncomfortable. You can ask them to stop at any time.
Past trauma or sexual violenceTell the nurse when you book or at the start, and ask for a double appointment. The My Body Back Project runs clinics for people who have experienced sexual violence.
AnxietyBring someone with you or ask for a chaperone. Ask to see the equipment first and have each step explained.
Not having time or struggling to get an appointmentThe test takes about 10 minutes. Ask about early, evening or weekend appointments, or a sexual health clinic. Employers can support staff to attend.
Disability or a learning disabilityAsk your GP surgery for reasonable adjustments, such as a longer appointment, a different couch or an easy read guide.
Language or cultural concernsYou can ask for an interpreter and for a female nurse. Easy read and translated guides are available on GOV.UK.
Thinking you don't need itScreening is recommended even if you've had the vaccine, have one partner, have female partners only, or haven't had sex for a long time.
Being trans or non-binaryAsk your GP or a sexual health service for an appointment, and to be added to invitations. You can ask that your gender is respected in the room.

If you've been invited but not attended, you may be offered an NHS home testing kit (see below).

Your results

  • HPV not found. Your risk is very low. You don't need any further tests, even if you've had abnormal results before, and will be invited again in 5 years.
  • HPV found, no cell changes. This is common. You'll be invited for another test in about a year to check if your body has cleared the virus.
  • HPV found with cell changes. You'll be invited for a colposcopy, where a specialist looks more closely at your cervix. Any changes can usually be treated there and then. Finding cancer at a colposcopy is very rare.
  • Inadequate sample. Sometimes the lab can't get a result. You'll be asked to have the test again in at least 3 months.

Home testing kits

From 2026, the NHS in England is offering HPV self-testing kits to some people who haven't attended screening after previous invitations, starting with those aged 30 to 65. You use a swab to take a sample from your vagina at home and post it back. If HPV is found, you'll be invited for a standard screening test. Home kits are invitation only.

NHS information and support

Common misconceptions

"I haven't had sex for years, so I can stop going."

HPV can stay in the body unnoticed for many years. Keep going for screening when invited, even if you haven't had sex for a long time.

"A normal result means I can't have any gynaecological cancer."

Screening only checks the cervix. It can't detect cancers of the womb, ovaries, vulva or vagina, so see your GP about any unusual symptoms.

"A smear test tells you if you have cancer."

It's a prevention test. It looks for HPV and early cell changes so they can be treated long before cancer could develop.

"I'm in a same-sex relationship, so I don't need screening."

HPV is passed on through any intimate skin-to-skin contact. Everyone with a cervix should be screened, whoever their partners are.