Cervical screening (smear test): UK guide 2025

Quick overview

• Who: Everyone with a cervix aged 25–64 (and some people outside this range in follow-up) is offered cervical screening.
• What: It’s an HPV first test. If high-risk HPV is found, your sample is also checked for cell changes.
• Where: Usually at your GP surgery or a sexual health clinic. Some areas offer self-sampling kits for people who are overdue.
• England 2025: From 1 July 2025, if you test HPV negative your next invite is typically in 5 years (see details below).

Who needs screening

• All women and people with a cervix aged 25–64 should attend when invited. If you’re 65+ you’ll only be invited if your recent tests were abnormal, but you can ask for a test if you’ve never been screened or not since 50.
• Trans men and non-binary people with a cervix: you’re eligible. If you’re not automatically invited (for example if registered as male), ask your GP to add you to recalls.
• Immunosuppressed (for example, after transplant, on long-term immunosuppressants, or living with HIV): you may need more frequent follow-up. Your specialist or GP will advise.
• Pregnancy: routine screening is usually delayed until 12 weeks after birth unless you’re already in follow-up.

England 2025 update (intervals)

From 1 July 2025 in England, if your cervical screen is HPV negative your next invite is usually in 5 years. This applies at ages 25–49 and 50–64. It does not change any due dates you were already given before 1 July 2025. If your previous screen in the last 5 years was HPV positive, you may still be invited sooner to ensure safe monitoring.

Why safe? Because a negative high-risk HPV test has a very high negative predictive value—the chance of developing cervical cancer in the next five years is extremely low. This allows fewer, better-targeted screens without missing cancers.

Differences across UK nations

• Scotland & Wales: Routine invites are typically every 5 years for ages 25–64 (HPV primary screening).
• Northern Ireland: Ages 25–49 are commonly invited every 3 years and 50–64 every 5 years (check your letter).

What the test actually checks

• A soft brush collects cells from the cervix. The lab first tests for high-risk human papillomavirus (HPV), which causes the vast majority of cervical cancers.
• If HPV is found, your sample is examined for cell changes. If none are found, you’re usually invited again in a year to check if HPV has cleared. If changes are found, you’ll be offered colposcopy (a closer look at the cervix).
• If HPV is not found, you return to routine recall (now typically 5 years in most of the UK).

Results: what they mean

• HPV negative: very low risk; routine recall.
• HPV positive, no cell changes: repeat in 1 year. If HPV persists for 2 years, you’ll be offered colposcopy.
• HPV positive, cell changes present: colposcopy to assess and treat if needed.
• Unclear/inadequate: repeat test (usually in ~3 months).

Most HPV infections clear by themselves within 1–2 years.

At-home HPV self-sampling

Self-sampling kits (vaginal swabs or, in studies, urine devices) can increase screening in people who are overdue. UK programmes are expanding targeted offers for under-screened groups, with national bodies consulting and evaluating how best to roll this out safely.

• If your self-sample is HPV positive, you’ll need a clinician-taken sample (or colposcopy) for triage.
• Self-sampling is an option in some areas; it does not replace clinic screening for everyone.

Special situations

Pregnancy & postnatal

Routine screening is usually delayed until 12 weeks after birth to reduce unclear results. If you already had abnormal results or are in follow-up, you may still be assessed during pregnancy (colposcopy is safe in pregnancy).

Immunosuppression (including HIV)

Higher risk of persistent HPV. You may be offered more frequent surveillance and earlier colposcopy according to NHS guidance. Your specialist team will advise.

IUDs, menopause, vaginal dryness

Screening is safe with an IUD in place. If post-menopausal dryness makes screening uncomfortable or samples are repeatedly inadequate, your clinician may suggest short-course vaginal oestrogen before a repeat.

Trans & non-binary people

If you have a cervix, you’re eligible. If you’re not being invited automatically (for example registered as male), ask your GP to add you to recalls and request any reasonable adjustments you need.

Prepare & make it more comfortable

• Book for the middle of your cycle (not on your period).
• Avoid vaginal creams, lubricants or pessaries for 2 days before the test unless prescribed.
• Tell the nurse if you’ve had discomfort previously — you can ask for a smaller speculum, change positions, pause, or stop at any time.
• You can request a female clinician and ask for a chaperone.
• If you’re anxious, trauma-informed adjustments are available — longer appointments, clear step-by-step explanations, and control over pacing.

After hysterectomy or trachelectomy

• Total hysterectomy (cervix removed) for non-cervical reasons: you generally no longer need screening and should be removed from recall.
• Subtotal (supracervical) hysterectomy: you still have a cervix — continue routine screening.
• After treatment for CIN/CGIN: follow test-of-cure and long-term follow-up schedules advised by colposcopy (initial test around 6 months; longer follow-up may apply, especially for CGIN).

HPV vaccine & screening

• The NHS now uses a one-dose HPV schedule for most people under 25 (more doses if immunosuppressed or if starting at older ages).
• Still attend screening even if vaccinated — the vaccine doesn’t cover every HPV type and screening remains essential.
• Vaccination plus screening is how the UK plans to eliminate cervical cancer by 2040.

Barriers & reasonable adjustments

If you’ve delayed because of pain, previous trauma, disability, cultural concerns, or dysphoria, you are not alone. You can ask for:

• Extra time, a quiet room, step-by-step consent at each stage.
• A named clinician, female clinician, or familiar setting.
• Positioning aids, hoists, or accessible facilities.
• Information in accessible formats and an advocate or supporter present.
• Consider targeted self-sampling if offered locally and you’re overdue.

How to book

1. Check your invite (NHS App, text, or letter). If you missed one, contact your GP surgery — you do not need to wait for a new letter.
2. Tell reception about any adjustments you need (for example, female clinician, longer slot).
3. After your test, your result letter explains the next step and when you’ll be invited again.

Support & further help

If you’re worried about symptoms, call your GP. For urgent concerns, use 111. In an emergency, call 999.

Glossary

• HPV: Human papillomavirus; certain types can cause cervical cancer.
• HPV primary screening: Testing for high-risk HPV first; cytology only if HPV is found.
• Colposcopy: Outpatient exam to closely inspect the cervix.
• CIN/CGIN: Precancerous changes in squamous/glandular cervical cells.
• Test of cure: Follow-up testing after treatment to ensure HPV has cleared.