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Why most of what you believe about smear tests is probably wrong

Sophie Cullinane
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I hate going for smear tests. I’m frightened of them. A fact certainly not helped by the not-so-distant memory of going for my first cervical screening nearly four years ago.

I was visibly nervous about getting my vagina out in front of a complete stranger on a drizzly Tuesday morning without the aid of a cocktail and my ‘kooky’ nurse attempted to relax me by talking very loudly about how wasted she’d got over the weekend.

Feeling not at all eased, I was told to undress and put my legs in stirrups whilst she washed her hands, put on some gloves and prepared to take a sample of my cervix. I was trying to pretend the whole thing wasn’t happening until the nurse took one look at my vagina and squealed "Oh my god!" I went hot with panic until I noticed the nurse was sniggering. "You should have seen the look on your face," she squealed. "I was only joking, you silly thing! You just seemed so nervous."

If there’s a more inappropriate time to play a prank on someone, I am yet to hear of it.

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Neurotic? Maybe. Traumatised? Absolutely, but self-esteem obliterating ‘jokes’ aside, I'm certainly not the only otherwise health-conscious woman in her 20s who’s somewhat lackadaisical about keeping up to date with my cervical screenings.

More than one million women in the UK are putting their lives at risk by missing potentially life-saving cervical screenings according to alarming figures from the Health and Social Care Information Centre (HSCIC). In 2014, about 4.3 million women aged between 25-65 were invited to attend smear tests, but only 3.1 million were actually tested - a fall of 3.3% from the previous year, when 3.23 million underwent a cervical smear test. Women aged 25-49, who had not been tested for three years, had the lowest uptake at 71.2%, which doesn’t paint the most flattering picture of young people and their willingness to take this vital check up seriously.

I drink green juice every morning, I’ve given up smoking, I walk to work every day and I regularly check my breasts for lumps. Scientists and experts estimate that cervical screening saves around 4,500 lives each year in the UK, so why do I and women like me have such a block when it comes to cervical screening?

According to GP Dr. Sarah Lonsdale, who has been performing cervical screening for 10 years, a lot of the problem can be accounted for by a general misunderstanding of what the smear test is for, what it actually involves and the perceived risks involved. Enough’s enough, people - we've debunked the most commonly-held myths to obliterate any excuses you might be using to avoid booking yourself in for a cervical screening.

Jade Goody memorialGetty Images

Myth one: you have to have them every year

"Since Jade Goody died of cervical cancer, there was a public call for women to be able to go for a smear test whenever they’d like," Dr. Lonsdale explains. "However, the current system on the NHS means that you will go in for your first screen test at 25, and then every three years until you’re 49, when you will go every five years. Of course, it is possible for women of all ages to develop cervical cancer - as the Jade Goody case highlighted - but the condition is still extremely rare in women under 25."

Myth two: a cervical smear test is designed to detect cancer

"The point of a smear test, despite what most people believe, is not to detect cervical cancer, it’s to see if there are any pre-cancerous cells that have changed," Dr. Lonsdale tells us. "If we do find anything that has changed, it doesn’t necessarily mean you have cancer as some of these cells respond to treatment. If this happens, you’ll need to come in for another test in six months to see if your cells are normal or ‘adequate’. If that test comes back as ‘abnormal’, then you will have to have a further test to see if you’ve got cervical cancer. Around one in 20 women will come back with an abnormal result from their test, not all will develop cervical cancer - there are around 3000 cases of cervical cancer in the UK per year which, if you consider the amount of women who get tested, puts it into perspective. Smear tests are preventative rather than diagnostic."

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Myth three: it will hurt

"A cervical screening should never be painful," Dr. Lonsdale insists. "It will likely cause you some minor discomfort, but if it causes you pain you must let your doctor know, as this could be an indication that you have another condition, such as thrush, which might need treatment."

Myth four: cervical cancer is a young women’s disease

"The perception is that cervical caner only happens to young or pre-menopausal women," says Dr. Lonsdale "but, in fact, half of deaths occur in women over the age of 65."

Myth five: the nurse can tell how many people you’ve had sex with

"There is no way to tell how many people you’ve been intimate with when they give you a cervical smear," Dr. Lonsdale says. "The idea that someone who has not had sex has an extremely tight vagina is something of an urban myth these days, as so many young people use tampons for long periods before they become sexually active. Likewise, there are many reasons why you might feel your vagina is lax; for example, if you’re slightly heavier in weight, this can put pressure on your pelvic floor. Sexual activity will never change the size and shape of your vagina. It is also important to note that you will still need to come in for a smear if you’re not sexually active - abnormal cells can develop regardless of your sexual activity."

So, with those myths dispelled and some of our concerns alleviated, where does that leave those of us who have been nervous about phoning our doctors and booking ourselves an appointment? Yes, it’s nerve-wracking and, yes, it’s potentially embarrassing, but with our health at stake and the possibility of preventing a potentially terminal illness from developing, it’s really a no-brainer.

First published 12 September 2016.