cervical smear (when an unscheduled smear is not indicated)

Last reviewed 11/2020

Additional cervical screening is NOT recommended in women who fall under the age group to be screened and who have had a screening test done within the previous 3-5 years even in any of the following situations:

• women who are taking or starting to take oral contraceptives or hormone replacement therapy (HRT)
  
  
• insertion of an intrauterine contraceptive device (IUCD)
  
  
• in women who has
  • genital warts
  • vaginal discharge
  • pelvic infections
    
    
• in women who have risk factors like
  • multiple sexual partners
  • heavy cigarette smokers
    
    
• women who are pregnant - either antenatally, postnatally or after termination unless a previous screening test was abnormal (1)
  
  
• women younger than 25 years of age in England and younger than 20 years of age in Scotland and Wales
  
  
• women older than 65 years of age who have had three negative samples
  
  
• if the woman has symptoms of possible gynaecological cancer. This includes (3):
  • postmenopausal bleeding. If the woman has postmenopausal bleeding and has attended regular screening, do not take a cervical sample. Examine and refer urgently (within 2 weeks) to a gynaecologist
    
    
  • suspicious-looking cervix - urgently refer the woman (within 2 weeks) to a gynaecologist. A cervical sample may be taken and suspicious looking cervix recorded on the form. The cervical cytology result may confirm cancer, but a negative result does not exclude cancer
    
    
  • abnormal bleeding (post-coital bleeding, intermenstrual bleeding, and blood-stained vaginal discharge) - urgently refer the woman (within 2 weeks) to a gynaecologist

Reference:

• 1. NHS Cancer Screening Programmes 2010. Colposcopy and programme management. Guidelines for the NHS cervical screening programme 2nd edition
• 2. Scottish Intercollegiate Guidelines Network (SIGN) 2008. Management of cervical cancer: a national clinical guideline
• 3 CKS (2010). Cervical screening.