Cervical Screening FAQs - Your cervical screening (smear) test invitation

In Wales, people between the ages of 25 and 64 are invited for cervical screening every five years. It normally takes many years for cervical cancer to develop from any cell changes that may happen in the cervix. Screening every five years can pick up these changes before they become cancer.

The only people who are screened more often are:

• People who have been seen in a colposcopy clinic, who might need more frequent tests for a period of time
• People with HIV are advised to have screening every year, even if no high risk HPV is found
• People who have high risk HPV found on their screening test but no cell changes

If you have no high risk HPV found on your screening test, you cannot be screened again any sooner than five years.

In Wales, individuals who can have cervical screening are invited up to the age of 64. The screening programme stops then because individuals who have no HPV (human papillomavirus) at this time are very unlikely to go on to develop cervical cancer in later years.

Although cervical cancer does occur in older individuals, it is often in people who have had no screening, or who have not had enough screening tests in the past. Even if all of your past tests were normal, it is very important that you report any unusual bleeding, discharge or other symptoms to your doctor. This includes:

• Bleeding after sex, between periods or after the menopause
• New or different vaginal discharge (change in colour, amount or consistency)
• Lower tummy or back pains, or pain during sex

If you have never been for a cervical screening (smear) test you can ask at your doctor’s surgery to have one, even if you are over the age of 65.

In Wales, you are invited for cervical screening from age 25 until age 64. Cervical screening is not recommended for anyone under 25 years old.

Cervical cancer is very rare in people under the age of 25, and cervical screening hasn’t been shown to reduce cancer cases in this age group. Most cell changes in this age group will go away on their own. Screening individuals under the age of 25 can lead to treatment which may not be necessary.

If you are under 25, you will have been offered the HPV vaccine at school. If you had the vaccine, then you will have a lower chance of having HPV. You will be invited for your cervical screening (smear) test when you are due at 25. It is still important to attend even if you have had the vaccine, as it does not protect against all types of HPV.

Even if you did not have the HPV vaccine, you still do not need a cervical screening (smear) test until the age of 25.

If you have are having any symptoms, such as irregular bleeding, discharge or pain during sex, it is important that you see your doctor.

Your invitation for screening usually arrives a couple of months before your 25th birthday. You can go for screening straight away, you don’t need to wait for your 25th birthday if you have had your invitation letter.

Sometimes Cervical Screening Wales (CSW) does not know that you have had a hysterectomy, so they continue to invite you for screening. Your doctor can inform CSW about your hysterectomy and we can then stop your screening invitations.

A hysterectomy removes the uterus (womb) and this usually includes the cervix (neck of the womb). This is called a ‘total hysterectomy’. Sometimes the cervix may be left in place, this is called a ‘subtotal hysterectomy’. If you have had a ‘sub-total hysterectomy’, you should continue having cervical screening (smear) tests up to the age of 65 years. Your doctor will be able to tell you what type of hysterectomy you have had.

After a total hysterectomy you would not normally need any further screening tests.

However, if a further screening test is needed,  your gynaecologist will let you know.

Having cervical screening is your choice. Cervical Screening Wales has a duty to invite all eligible individuals for screening.

If you do not attend for a screening test within six months of your invitation letter, you will be sent a reminder letter. If you do not attend after your reminder letter, you will not be sent a letter for five years. You can attend for screening at any time after you have been sent an invitation.

Individuals who ask for their invitation letters to be stopped, but then later decide that they would like to have screening, can come back into the programme at any time until the age of 64 (or older if they have never been screened).

We will usually send you a form to fill in, because we need to be sure that you understand what might happen if you choose not to be screened.

If you do not want to receive  invitations for cervical screening, you can contact Cervical Screening Wales.

You may be happy to be sent your invitation letters and to decide whether to attend or not, each time you are sent them.

The UK National Screening Committee has recommended that cervical screening programmes invite all people with a cervix, aged between 25 and 64 every five years once they have tested negative for HPV.

Human papillomavirus (HPV) is a virus that causes nearly all cases of cervical cancer. In 2018, Cervical Screening Wales introduced screening using HPV testing. This test is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer.

Evidence shows that it is safe to extend the time between cervical screening (smear) tests for people who do not have HPV. Cervical Screening Wales made this change from 1st January 2022.

This change applies to people whose next routine screening result shows that they do not have HPV. This means their risk of developing cervical cancer within the next five years is very low.

We will look at the cells if high-risk HPV is found in a cervical screening sample. Follow-up for these individuals may be different depending on their test results.

Yes. Evidence shows that if there is no high-risk HPV found in an individual’s sample, they have a very low risk of developing cervical cancer within five years. It takes around 15 to 20 years to develop an infection with HPV, in people with normal immune systems.

The change has applied since January 1st 2022 to people receiving routine results, where HPV was not found. Individuals who are already receiving care in colposcopy, or are due to have follow up cervical screening, will not be affected by the change until they complete their follow up tests and return to routine recall, after testing negative for HPV.