Cervical smear tests

Having regular smear tests every three years is the best way of finding and treating abnormal cell changes and preventing cervical cancer from developing.

Cervical cancer and human papillomavirus

• Cervical cancer is caused by the human papillomavirus (HPV). HPV is a sexually transmitted infection that affects almost all people at some point in their lives. 
• There are many types of HPV. Most HPV infections will clear up by themselves. 
• Only a few types of HPV will lead to abnormal, precancerous cells that could progress to cancer. 
• Although there is no treatment for persistent HPV infections, there is treatment for the abnormal cells that HPV can cause.

Who should have cervical smear tests?

All women aged 20 until they turn 70 who have ever been sexually active should have regular smear tests. Women who have had a hysterectomy (removal of the uterus) need to check with their doctor or smear taker whether they still need to have cervical smear tests.

Women who have been HPV immunised should continue to have regular cervical smears because the vaccine does not protect against all the virus types that can cause cervical cancer.

Where can I have a cervical smear test?

The choices include: 

• your doctor or practice nurse 
• the Family Planning Association (FPA) 
• your sexual health service 
• marae-based or other Maori health centres 
• community health centres, eg, Pacific health centres and 
• women’s health centres.

Most of the above services have women smear takers.

The cost of a cervical smear test will be what you would normally pay to see your doctor or nurse. Some community or primary health organisations offer a free or low-cost service.

How often do women need a cervical smear test? 

• Women are advised to have a cervical smear test every three years. Research shows very little extra benefit from having more frequent smears. 
• Cervical cancer usually takes many years to develop.  Any abnormal cells can be found and treated to stop them from becoming cancer. 
• If this is your first cervical smear test, or if you have not had a test for over five years, you will be advised to have a second test in a year’s time. 
• In some circumstances, you may be advised to have a test more often, eg, after an abnormal result.

Cervical cancer in New Zealand

*Estimated New Zealand figures.

The cervical smear test

You will be asked to lie on your side or your back with your knees bent up. The lower part of your body will be covered with a sheet. The smear taker gently opens the vagina with a speculum and carefully takes a sample of cells from the surface of the cervix with a tiny brush or broom. This process will take only a few minutes. The sample of cervical cells is placed into a liquid solution that preserves the cells for testing (called a liquid-based cytology test or LBC). The sample is then sent to a laboratory to be examined.

Some women may find the test uncomfortable but it does not usually hurt. If you are embarrassed or nervous, tell your smear taker how you feel. You can take a support person with you if you wish. It is best not to have the test during your period.

In some situations, women having a cervical smear test will also be offered an HPV test. The HPV test looks for high-risk types of human papillomavirus, which can cause cell changes. The HPV test is performed on the same sample as the smear test. If you have an HPV test, the laboratory reports the results to your smear taker at the same time as your cervical smear result.

Cervical smear test results

Cervical smear tests are a very good screening tool, but they are not perfect. There is a small chance that some abnormal cells will be missed during sampling or slide reading (called a false negative). Abnormal changes to cervical cells progress very slowly. It is likely that any abnormal cells missed at one regular check will be picked up at the next. 

Some women may be asked to come back for another test if there were not enough cells to test.

If you have an abnormal result you may be called back for other tests. An abnormal result hardly ever means cancer. If a woman has been told her smear is abnormal, she will have a further smear or be referred for colposcopy. The results from these tests may show there are no abnormal cells and no treatment may be needed.

The Cervical Screening Programme also has a useful pamphlet called Cervical Screening: Understanding Cervical Smear Test Results (code HE4598).

Getting your cervical smear test results

You will need to contact your smear taker to get your results. They will usually take from two to four weeks. The programme will only contact you if you have had an abnormal result. You will be informed by mail and also advised about any follow-up needed.

How abnormal cells are treated

If you have an abnormal smear result, you may be advised to have a repeat smear test within the next few months and, if necessary, colposcopy.

Colposcopy is an examination of the cervix, using a colposcope. The colposcope looks like a pair of binoculars on a stand. It magnifies the cervix and vaginal wall so that the abnormal cells can be found. (The Cervical Screening Programme also has a useful pamphlet called Colposcopy (code HE1202).)

Ma te mohio ka ora
"Knowledge improves health and well-being"

AN IMPORTANT MESSAGE

See your doctor if you have:

• bleeding or spotting between menstrual periods
• bleeding or spotting after sexual intercourse
• bleeding or spotting after menstrual periods have stopped (after menopause)
• persistent pain in your pelvis
• pain during sexual intercourse
• unusual discharge from the vagina. The discharge might be smelly, have changed colour from white to pink, brown, or green, or be streaked with blood.

These symptoms can happen for several reasons and rarely mean that you have cervical cancer. However, they should be checked by your doctor.

The National Cervical Screening Programme

The programme aims to prevent cervical cancer. All women who have cervical smears are part of the programme unless they say that they do not want to be.

The benefits of recording cervical smear test information include: 

• ready availability of records to you, your smear taker and the laboratory reading your tests 
• automatic reminder letters when you are overdue for having a cervical smear test 
• checks to ensure the right follow-up after an abnormal smear test 
• planning for the needs of different ethnic groups.

The programme is checked regularly to see that it is working well and it is measured against national quality standards to help all women get the best possible screening and treatment.

What information is collected?

The information collected by the programme includes your personal and contact details, relevant clinical history, cervical results and any treatment details. This confidential information is stored on a computer system called the NCSP Register. Only authorised personnel have access to information stored on the NCSP Register. The National Screening Unit of the Ministry of Health ensures that all information is held securely.

For more information about the legislation governing the NCSP, ask to see the booklet Prevention of Cervical Cancer: A Guide for Women in New Zealand (code HE1328).

• Any woman can withdraw from the programme at any time by filling in a form or by writing to the programme. 
• In order to ensure no follow-up, your name, address, date of birth and national health index number will be kept, but the programme will not track your smear history. 
• You can rejoin the programme at any time, and your screening history with the programme will recommence with your most recent smear.

Further information

Read the free booklet Prevention of Cervical Cancer: A Guide for Women in New Zealand (code HE1328), obtainable from your doctor or smear taker.

Visit the National Cervical Screening Programme website: www.cervicalscreening.govt.nz

View this pamphlet and other health education resources at www.healthed.govt.nz

Contact:

• the National Cervical Screening Programme, freephone 0800 729 729 
• your doctor or practice nurse 
• Pacific health centre, marae-based or other Maori health centres 
• your local women’s community health centre 
• your local Family Planning Association (FPA) 
• your local Cancer Society.

For more information contact the National Screening Unit, the Ministry of Health, phone Wellington (04) 496 2000.

Notify change of address

If you change your address, please advise your smear taker and the National Cervical Screening Programme, freephone 0800 729 729.

Related topics

Cervical cancer - causes and prevention and What is cancer?

Original material provided by the National Cervical Screening Programme. Reviewed November 2011.