Smear Tests – Why Aren’t We Getting Them?

Author: Naomi Liddell

Recently in our group chat, Laura reported that the uptake for routine smear tests has fallen to a 20 year low. And pretty much 100% of the team were shocked.

The government has now launched a campaign to rebrand the test. By renaming it cervical screening, the hope is that this will change the public attitude. You might be reading this wondering what the public attitude is?  Well, research conducted by Jo’s Cervical Cancer Trust uncovered some interesting statistics…

Of those interviewed: 

  • 37% thought screening did not reduce your risk of disease
  • 35% of all women report being embarrassed to attend because of their body shape
  • 34% had concerns over the appearance of the vulva 
  • 38% were concerned about whether they smelled “normal” 
  • 31% said they wouldn’t go if they hadn’t shaved or waxed their bikini area
  • 35% wouldn’t go if they had to take time off work
  • 16% wouldn’t miss the gym to attend
  • 14% would rather miss a smear than a waxing appointment
  • 20% would rather not know if something was wrong
  • 30% of those who had never had a smear said they didn’t know where to get the test


What Happens at a Smear Test / Cervical Screening?

As you probably know, phoning your GP surgery and asking for a cervical screening is your first step.  In terms of what actually happens during the screening, we’ve lifted this straight from the NHS website in order to be as accurate as possible. But urge that if you have any concerns or questions that you visit the website to see what your best referral route is, and of course, make an appointment with your GP. 

  1. You’ll need to undress, behind a screen, from the waist down. You’ll be given a sheet to put over you. (RMS tip: wearing a skirt or dress can help make you feel a bit less exposed at this point)
  2. The nurse will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart. Sometimes you may need to change position during the test.
  3. They’ll gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant should be used.
  4. The nurse will open the speculum so they can see your cervix.
  5. Using a soft brush, they’ll take a small sample of cells from your cervix.
  6. The nurse will close and remove the speculum and leave you to get dressed. 

Please know that you are in full control of your experience and by feeding back to the nurse how you’re feeling (nervous/uncomfortable/pain) they can respond appropriately. At any time you can tell the nurse to stop. 


Our Thoughts On Smear Tests



“For me personally, smear tests have never really been an issue. Yes, it’s a bit uncomfortable to be lying legs akimbo making small talk with a stranger. But so is lying with your mouth clamped open being asked about your holidays at a dentists visit. For people in these professions a vagina is a vagina, is a vagina. The nurse couldn’t give a toss about whether I’ve made my waxing appointment or not. 

Cancer is quite prevalent in my family. And unfortunately, that’s a truth for many people. And having witnessed people fight with, die from and in the best cases survive the disease, it’s safe to say that I will do anything in my power to catch anything sinister going on in my own body early. 99.8% of cervical cancer cases are preventable. 99.8%!!! With most cases caused by untreated infections. This… Is why it’s important. Because something as simple as an unnoticed infection can cause cancer. And you can prevent that from happening, for free, by making a very simple appointment.”


“I have been having regular smears since I was a teenager, about 16 for medical reasons. To me, it has never felt invasive or something I should be embarrassed by. It’s a quick medical procedure carried out by a professional that, by the way, we are so incredibly lucky to have available to us, let alone for free!

As I was young when I first started my smear experience I can’t quite understand why older, more wisely women aren’t making these appointments. Smears check for abnormal cells in the surface of your cervix. There are varying layers. CIN 1, CIN 2 and CIN 3. 2 and 3 carry a higher risk of turning into cervical Cancer which is why it is so very important to book in for your smear appointment. If you are found to indeed have abnormal cells you might have to go for another smear or you a Colposcopy appointment will be made for you, which is actually pretty cool because they use a teeny tiny camera and explore the area and you can watch on a screen. There are a few treatment options to remove CIN 1 or 2.

I have had both male and female professionals conduct my smears, been walked in on by another medical professional, had a smear with a baby on my lap (mine obviously) and I will only ever be grateful to have had CIN 2 removed and forever thankful I was under regular observation where my cells weren’t left to develop in to Cancer.

Please book your appointments ladies.”



“I genuinely get a bit emotional when I think about the NHS and how lucky we are to have it.  This was particularly strong when I first received my letter AND text message that I was due to have a smear test.   
The day I received the notification I called up my doctor’s surgery, booked the appointment, and within that same week (I, along with the rest of the country, always have the long wait on the phone, but generally my surgery is very good and I can get an appointment for later that same week) I found myself lying spread eagle (sort of) on a the bed.  
Having a smear is not the most enjoyable experience but I genuinely found it less painful than having a tattoo and less awkward than having a wax.  Both of which I paid for.  And they certainly haven’t saved my life.
If I felt body conscious throughout the (literally) 3 minutes that I was lying down for, I forced myself to think ‘This person is a medical professional.  They see so many vaginas a day, a week, a month, mine is nothing special to them’. 
I feel incredibly fortunate to live in a country and a time where it’s possible for us to have something so readily available that genuinely saves lives.  Please, go and have a smear.  Your body will thank you for it.”
It does need to be said that whilst we make light of the smear test process in this post, we know that there are potentially readers who have either experienced trauma or have very real fears surrounding having this type of screening done. To which we would say, make an appointment with your GP to discuss your concerns. If the numbers are anything to go by, you are most certainly not alone and there are procedures in place to offer you the support you need. This is a free screening that could potentially save your life. 
Naomi loves daytime baths, learning things and rock music.
(Oh and her kids. She loves them too)
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30 thoughts on “Smear Tests – Why Aren’t We Getting Them?

  1. I can’t understand anyone having an issue with getting a smear test. It is so important. Yes it’s not particularly pleasant but I have always had a good experience every time I have had one. Once every three years is not a lot is it?
    The nurse always makes me feel very comfortable and makes sure I am happy during every step of the procedure and it takes less than 5 minutes.

    It’s great that you have highlighted this in a blog post and I really am astounded by those statistics!

    1. The stats are shocking aren’t they Katie? And you’re right. Once every 3 years (for most) is totally doable, especially considering the importance.

    2. I can’t believe I made it as far as the comments without anyone mentioning what it’s like for trauma survivors. It must be nice to see this as a thing that’s silly to worry about! Not all of us are that lucky.

      1. Hi Emily, I’m not sure if you read the end of the post but we did acknowledge that obviously, this is a much more difficult topic for those that have experienced trauma and people with genuine fear about the procedure.

  2. So I have a personal story to share on this, which has forever shaped my opinion on smear tests, and their importance.

    My Grandmother worked in the canteen of a University Hospital in the 60s, and one day the Professor studying womens health at the University called all of the female workers there into a meeting, and announced that they were pioneering smear tests as a trial, and that it had been introduced as a really effective way to detect cervical cancer etc. He asked if all of the workers would like to take part in the study. Every single lady agreed, apart from my grandmother, who felt uncomfortable about it, so didnt take part.
    She died two years later at 39 from cervical cancer, leaving behind a 13 year old (my dad) and a 2 year old (my aunt). She is missed so much by them still.

    It is frustrating to us as a family, that if she had taken part in the study, it could have been detected earlier.
    Thats why, I will never miss a smear test, and I cannot state the importance of them enough. They save lives.

    Thank you for raising such awareness of this issue.

    1. Betty…I don’t even know what to say. I’m all welling up. Thank you for taking the time to share your family’s story. It goes a long way towards highlighting the importance to anyone reading who may be hesitant to go. It’s such a shame that women still to this day are so embarrassed about our bodies that we would put something as important as this on the back burner.

  3. This is a very timely post. I had my second ever smear this week, 14 years after my first.

    Unfortunately, my first experience was horrendous and left me deeply afraid and traumatised. It was conducted by a doctor at my six-week post-natal check after my daughter was born. It was a disaster from start to finish and I left the sugery bleeding and in pain. It shouldn’t be like that. I was very unlucky.

    I’ve booked and cancelled appointments so many times over the years. Finally, I had a chat with the Nurse Practicioner at my surgery and she agreed to help me overcome my fear. My advice to anyone going through similar is to ask for the most experienced nurse, someone who’s done hundreds and knows all the tricks. I have a tilted cervix, which is apparently very common, but probably threw the original doctor off because she didn’t conduct smears very often. This time, the nurse asked me to place two fists under my bum. Apparently her view was vastly improved!

    It genuinely wasn’t easy. I cried before and after. If you can’t understand why anyone would find a smear difficult, please stop and think. There are lots of reasons someone might be traumatised. Sexual abuse, birth trauma, a family history of cervical cancer. It’s more than just being a little embarrased.

    1. Franky this is such an important comment to leave. Thank you for being so open about it. I wrote at the end of the post that those who experienced trauma might find it difficult to get the screening, but that it’s important to seek the support needed. You’re proof of that. Massive well done on going through with it and asking for help. As you said, it wasn’t easy, but you also know how important it is too.
      Your nurse sounded awesome! (also I have a tilted cervix too and they always ask me to cough! Might try the fists-under-the-bum trick next time)

  4. I find the stat 99.8% mind blowing. And can’t fathom why that wasn’t used in the campaign – rather than a few alternative words for “smear test”. It is what it is, and it’s there to potentially save your life. The 20 year low makes me very very sad indeed, I just can’t understand it 🙁

  5. Such an important post!!! Thank you so much for posting and for encouraging. I know there are various reasons why people don’t want to go beyond feelings of embarrassment (thank you Franky for mentioning some of them and well done for going recently!!) but the statistics really do speak loudly and clearly, it is so important. You are absolutely right – nurses see a patient to test, they are not analysing what you look like or passing any form of judgement, and it is quick and free. And Franky excellent advice on talking to your nurse if there are any circumstances why going may present an obstacle or particular fear, they will most definitely understand and will do everything they can to help.

    1. The statistics are quite shocking, aren’t they Annie? But hopefully talking about it more and making it known that there is support for all women who feel unsure/insecure/trauma then hopefully more people will make their appointments.

  6. I was 22/23 when I had my first smear. I’d moved to London Bridge and registered at a new GP practice and they offered smears early due to (I think, but could be wrong as it was 11 years ago!) the high rate of teen pregnancy in the area. My results came back abnormal and after a successful procedure called loop diathermy at the hospital, was told my abnormal cells were CIN3 (high chance of becoming cancerous). I’ve had a smear every year following that and thankfully they’ve all come back clear. I had no sign that anything was up and I dread to think what could have happened if I hadn’t gone for that smear. It’s so important to do what you can to overcome any fear and get tested. Thank you for this post.

  7. Smears are such an important step in the prevention of cancer. The stat is absolutely shocking. I had no idea! Charlotte is right, their campaign should be that!
    I think it’s important to acknowledge for lots who will be experiencing their first smear it is normal to feel anxious for whatever reason, BUT the most important thing is being open with your nurse about it and not letting it override actually getting the test done.
    I had abnormal cells removed after I had my first baby, so therefore a smear, colposcopy, biopsy and cell removal with LLETZ and can genuinely say the worse thing about it all was the psychological worries rather than physical going on. I’m so lucky that they’re gone. We’re so lucky to have the NHS.

    1. You’re right Laura, it’s important to acknowledge that it’s totally normal to be scared and uncomfortable about the idea.

  8. I have always been good about going for my smear, after my first at 25 came back HPV positive I had to have them annually until my body cleared the infection (it took two years!). Since having my little boy I am ashamed to say I have made, and then cancelled, two smear test appointments, because the first time he was poorly with a temperature and the second time my husband was late back from work. Both of them were booked on a Friday evening at my local practice which happens to be the out of hours hub for the local area, which means they do smears out of normal hours in order to be able to get you an appointment more quickly. I have now had another reminder letter so am going to get booked in. It’s all very well us saying #selfcare on instagram with a picture of a bath or a magazine, but there is no greater self care than things like smear tests because they are genuinely life saving. Going to call right now and book my appointment so thank you for the reminder! xx

    1. You’re so right about the #selfcare thing India, team that with the crazy stats and the NHS would have a fantastic smear test campaign! Good on your for calling up to make your appointment. And don’t be ashamed that you cancelled. I’ve cancelled in the past too, but it’s important to rebook. Life can too easily get in the way, eh?

  9. I thought about not writing anything at all on this post as its still very painful for me, but there has been so much press recently that I guess I feel my situation may help or nudge anyone thinking ‘oh I am young and healthy, it won’t happen to me’, to absolutely go get their smear booked.
    I was 25 when I was diagnosed with cervical cancer. I hadn’t had a smear before but ironically had the letter and was due to book one while I was already having problems. I thought ‘oh they say 25 years old so I will be fine’.
    Anyway after months of radiotherapy and chemo I am fine now, unable to ever have children of my own but alive. I am now 34 and count my blessing that actually the NHS were able to provide me with excellent cancer care. Its still very emotional and painful to talk about. But the government should also be thinking about lowering the age again for smears.
    If anyone is reading this thinking ‘oh I am only young I will go next time’ DONT WAIT.

    1. So brave of you to share G, so glad you’re ok now. Totally agree about lowering the age, if they started earlier people might get in the habit sooner. Lx

    2. G I cannot tell you how much I appreciate you taking the time to give us your story. This is so important for any women reading who are young and feeling like it can’t happen to them. I am delighted that you’re out the other side and so sorry that it’s all still so raw.

  10. Just a quick update – read a news article this morning about the possibility of a urine test being made available that seems to be equally effective for first stage testing. It is being tested currently but so far the news looks promising. Hopefully that would also help those who do not wish to go for a “traditional” test for whatever reason in due course. Fingers crossed it works out. xx

  11. I had my 3rd smear yesterday, my first since having a baby last year. And boy was it different to the two before – having had so many checks and medical professionals having a look during my birth/post birth, I’m no longer so “worried” about exposing that area to a medical professional. In fact, she looked rather surprised that I was going to have it done with my 15 month old sat on my chest (why not? I bought snacks for the 30 seconds it would take to get her to sit still enough). To the point that I didn’t even give her a chance to draw the curtain before I’d whipped everything off and jumped on the couch. The quicker you do it, the quicker you’re back out! I feel having a baby changed this for me as it became normal to accept that they see them so bloody often that they’re really not bothered. Plus, if there is something wrong “down there”, they’ll tell you I’m sure, better to know then worry about nothing! I find it shocking that the numbers are so low for something so quick and relatively pain free – I really hope the campaign works.

    1. “she looked rather surprised that I was going to have it done with my 15 month old sat on my chest” Brilliant Jenny! What a champ!

  12. I’m a trauma survivor and I find smear tests very upsetting, painful and traumatic. Any time the topic comes up I get to read comments like “why would anyone have a problem with this” and nobody ever seems to get how difficult it can be. It is not worth it to me. I’ve read the stats and the benefits are overstated and I am sick of people preaching about how easy it should be.

    1. I’m glad you took the time to leave this comment. It is very important that people remember trauma can be a huge barrier to having a test like this done. I’m so sorry for the experiences you’ve had. But with respect, the benefits are not overstated. Statistically and scientifically, this is a life-saving test. And whilst we urge that every woman seeks the support they need to be able to attend their appointments, ultimately I know that even just asking for help can be a very difficult and personal choice.

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