Going for your cervical check in Ireland

If you have a cervix, from the age of 25 you are entitled to a free cervical screening from the HSE. During a cervical screening, also known as a smear test, a small sample of cells is taken from your cervix for testing to see if there are any cancerous cells. 

The test itself should take less than five minutes and the whole appointment should take about 15 minutes. If you feel nervous about going for a cervical screening, this is a common experience. Many people feel uncomfortable about going for their check, but it can be very beneficial to your health to have one. 

You may experience discomfort during the check, but you are able to stop the screening at any time for any reason. If you are feeling nervous or worried about having a check, speaking to someone about it before making an appointment can help. You can also speak to your healthcare provider on the day and let them know your concerns. They will be able to talk through your worries with you and give advice on how to relax during the check. 

In this article, you will find information on 

• What is a smear test?
• What is HPV?
• Booking your first cervical screening
• How is the cervical check done?
• Making the screening easier
• Giving consent to your cervical screening

Going for your cervical check in Ireland

What is a smear test?

The smear test or cervical check is a method of screening that detects pre-cancerous changes in the cervix (the neck of the womb). That means the test will show any abnormal changes that could lead to cancer of the cervix.

Your cervix is the opening of your womb from your vagina

What does the smear test detect?

A smear test can detect HPV (human papillomavirus) and changes in the cells of the cervix very early on, at a pre-cancerous stage. Cervical cancer can take 10-15 years to develop, making it a very preventable disease. After breast cancer, cervical cancer is the second most common cancer found in women and people with a cervix in Ireland. Every year about 300 people are diagnosed with cervical cancer.

It’s recommended that anyone with a cervix start having regular smear tests (every three years) from age 25. When you have your first smear test you’ll need to return for a second test three years later as part of the Cervical Check programme.

What is HPV?

HPV stands for human papillomavirus, which is a group of more than 100 viruses. 

HPV is very common and most people will be infected with a form of HPV in their lifetime. HPV infection is most common in people in their late teens and early 20s. You can come in contact with HPV by being sexually active with another person who already has the virus. Most HPV infections do not need treatment because your body can clear the virus itself. However, in some people, the HPV infection can develop into cancer or genital warts.

How do you get HPV?

You can get HPV by having vaginal, anal or oral sex with someone who has the HPV virus. It is most commonly spread during vaginal or anal sex. HPV can be passed from a person with no signs or symptoms, and using a condom can help to reduce the spread of HPV.

Anyone who is sexually active can get HPV, but symptoms can often take years to develop. This is why checking for cervical cancer is important. Although HPV is usually passed through sexual contact, a pregnant parent can also pass HPV to their baby during birth, but this is very rare.

Having your first cervical check 

When you turn 25, you will receive a letter from Ireland’s National Cervical Screening Programme, inviting you to go for your first free cervical screening. After your first screening, you will then be invited back every three years for a new screening. 

How do I book my smear test?

Once you receive your letter, you can book your cervical screening yourself through a GP or a clinic registered with Cervical Check. You can find your nearest registered clinic on the Cervical Check website. Once you find a clinic that suits you, call them to arrange an appointment. 

If you turn 25 and do not receive your letter inviting you for your cervical screening, you can still book the appointment yourself by calling a GP or registered clinic. 

When is best to go for your cervical screening?

It is best to try and book your appointment as soon as you get your invitation letter. If you missed your last cervical screening, you do not need to wait for a letter.

It’s best to book an appointment when you:

• are not on your period – also try to avoid the 2 days before or after you bleed
• have finished treatment for an unusual vaginal discharge or a pelvic infection, if you have one

You may have to delay having a cervical screening if you:

• are pregnant now
• have recently given birth
• have recently had a miscarriage or abortion

Does the cervical check hurt?

Having a cervical check should not be painful, but sometimes you might experience discomfort. Having a cervical check can be something you may feel nervous or uncomfortable about doing, and going for your first one may feel like a daunting task. If you are feeling nervous about your check, let your health care professional know before they begin the screening. If at any time you want the screening to stop, that is completely your choice and you do not have to do anything you do not feel comfortable with. 

Speaking to someone about your concerns before going for a check may help you work through some of the worries around the screening, and help you feel more comfortable with the process. Although it is recommended that you have a cervical check from the age of 25, it is not something that you have to do if you don’t want to. Having the check is completely your choice and no one should pressure you to have one if you do not want to.

Your cervical screening appointment

On the day of your cervical screening, it’s useful to bring your Personal Public Service (PPS) number with you. This will help to identify your correct records so that they can be kept up to date. Due to the COVID-19 pandemic, you will be asked to wear a mask during your appointment.

 In many GP practices and clinics, you will be able to:

• ask for a GP or nurse who is a woman or who has a cervix to take your screening test
• have a friend or family member in the room with you

Before starting, the GP or nurse should explain what will happen during the test.

You should be told:

• that your sample will be tested for HPV first 
• the benefits and limitations of screening
• the screening test process
• how your data will be shared
• to sign a consent form

If you have never had penetrative sex, you may find the test uncomfortable. Discuss this with your GP or practice nurse before the screening, as they are there to help you feel comfortable.

How is cervical screening done?

At your cervical screening: 

• you will be asked to undress from the waist down and lie on a bed. You can usually remain dressed if you’re wearing a loose skirt
• the GP or nurse will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart. You can lie on your side if it’s more comfortable for you
• they will gently put a smooth, tube-shaped tool (a speculum) into your vagina, this holds the walls of the vagina open. A small amount of lubricant may be used to help insert the speculum
• the healthcare professional will open the speculum so they can see your cervix
• using a soft brush, they’ll take a small sample of cells from your cervix
• they will then remove the speculum and leave you to get dressed
• they will put the sample in a pot to send to a lab
• the lab will check the sample for HPV first. If HPV is found, the sample will also be checked for abnormal cells

If you feel nervous about being touched, you can ask the person doing your check to talk you through what they are doing step by step. This can help you to feel more relaxed in the situation. You can also ask them to ask your permission before moving on to the next step in the screening process. Feeling nervous about the screening is a common experience and the practitioner will be used to patients needing support during their check. Voice how you are feeling and they will be able to help you try and relax during your cervical check. 

A speculum (plastic or metal) and a soft brush are used to take a sample of cells from your cervix

If you find the test painful or want to stop at any time, tell the GP or nurse as they will stop and may be able to reduce your discomfort.

Making your cervical screening easier

Things you can try that might make the test better for you include:

• speaking to someone about your concerns before the screening 
• wearing something you can leave on during the test, like a skirt or long jumper
• bringing someone with you for support
• take slow, deep breaths to help you relax
• asking the GP or nurse to use a smaller speculum
• asking the GP or nurse about lying in a different position

Will I bleed after my cervical check?

You may have some spotting or light bleeding after your test. This is very common and should go away in a few hours.

See a GP if you have:

• heavy bleeding after cervical screening
• any bleeding after the cervical screening that does not stop after a few hours

Consenting to your cervical check

You’ll be asked to give consent each time you have a screening test by signing a form called a cervical screening form. You’ll be given the form at your appointment and should be given time before your screening test to read it.

If you would like to see the form before your appointment, you can read it here. Only you can give your consent and no one should make you feel under pressure to do so.

Giving your consent is to confirm that you:

• have been told about cervical screening and its benefits and limitations
• understand this information
• have checked that your name, address and other details are correct
• allow us to receive, hold and exchange your personal information with those who deliver the programme

If you cannot sign the form, you will be asked to give your consent either verbally or by making a mark on the form. You can withdraw your consent at any time by contacting Cervical Check on 1800 45 45 55 or email by at [email protected]

What is informed medical consent?

Before signing the form, ask your GP or nurse any questions you have. This will help you give informed consent.

You should understand:

• the benefits and limitations of screening
• the possibility that your sample may also be tested for abnormal cells
• the likelihood and meaning of a normal result
• what it means if you are called back for further tests
• when and how you will get your result
• how your data will be shared with those delivering the programme

Most of this information will be given to you with the consent form. The information is also on the Cervical Check website. You do not have to sign the consent form if you do not want to. You should only sign the consent form when you feel you have all the information you need to make an informed decision.

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