How is it used?
Your doctor or health provider performs a cervical cytology test to look for cervical cells that are abnormal or even potentially cancerous. The cell suspension is processed in the laboratory and placed on a glass slide, stained with a special dye, and viewed under a microscope by a cytologist or pathologist. Abnormal cells can be present without causing any noticeable symptoms. Some of those screened may require treatment whilst others may require further testing or need to be monitored over a period of time to allow them to resolve on their own.
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When is it requested?
In England a woman registered with a GP receives her first invitation at the age of 25. There are three-yearly examinations between 25 and 49, and five-yearly examinations between 50 and 65.
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What does the test result mean?
A "negative" smear means the cells obtained appear normal. In some instances (less than 3 in 100), the sample may be reported as "inadequate" for evaluation. This generally means there are insufficient cells for reliable assessment. A summary of other reported results follows.
- Borderline changes: Cells present which may represent wart virus (HPV) infection or where there is uncertainty over their nature. The majority revert to normal without treatment.
- Mild dyskaryosis: Low grade changes often associated with HPV and which commonly improve without treatment.
- Moderate dyskaryosis: Abnormal cells present which may need treatment.
- Severe dyskaryosis: Abnormal cells present reflecting the probable presence of high grade pre-cancer (CIN) which is likely to require treatment.
- Severe dyskaryosis/?Invasive carcinoma: Abnormal cells present reflecting the probable presence of high grade pre-cancer (CIN) and cancer needs to be excluded.
- ?Glandular neoplasia: Abnormal glandular cells present which may arise from the cervix, the uterus (womb) lining or rarely the ovary.
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Is there anything else I should know?
Cervical cytology is used as a screening test in the well established national screening programmes. A small percentage of abnormalities in women may go undetected with a single test, which is why it is important to be screened regularly. The sample represents a only some of cells present on the cervix. Even for the most experienced nurse or doctor, sample collection can be occasionally insufficient and a repeat may be required (fewer than 3 in 100).
Cervical cytology, formerly the smear test, when performed routinely, has been a great help in the detection and treatment of cervical abnormalities known as Cervical Intraepithelial Neoplasia (CIN), which helps prevent cancer from developing. Early detection and treatment can prevent approximately 75% of cancers developing.
It is also important to realise that if you have any abnormal bleeding, for example, after sexual intercourse, between periods or after the menopause that you seek advice from your general practitioner about whether a gynaecological referral is needed. Cervical cytology is not appropriate in these circumstances.
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