Every woman looks forward to her cervical screening (‘smear’) test right? OK, so maybe not! Some of you at least will be relieved to know that cervical screening stops at 64. But why is this?
We offer cervical screening to women between the ages of 25 and 64. Invitations are sent every three years between the ages of 25 and 49, and every 5 years between the ages of 50 and 64. The test looks for abnormal cell changes on the cervix (the neck of the womb).
These changes are caused by a very common virus called the human papillomavirus (HPV). There are lots of different types or strains of HPV and a few ‘high-risk’ ones are the ones that can cause abnormal cells on the cervix. The virus is passed on very easily through sexual contact. It has no symptoms, so women wouldn’t know that they have it. Usually the body fights off the virus, a bit like fighting off a cold. But in some cases the body can’t do this. The virus persists, and that’s when abnormal cervical cells can develop.
Cervical screening tests for the HPV virus in one of two ways:
- as the first test carried out on the samples of cells taken at screening. This would be done as part of the HPV primary screening pilot which is running in some places in England
- as the second test on the sample after checking the cells themselves for any abnormalities (cytology). This is done on any screening sample that shows borderline or mild abnormal cells, to determine whether a referral for colposcopy is needed
There is currently a consultation in progress, looking at whether to replace cytology with HPV screening as the primary test across the cervical screening programme.
Why we stop screening at 64
Cervical screening prevents cervical cancer because it can find and remove abnormal cells before they have a chance to turn cancerous. Cervical cancer usually develops very slowly. It is estimated that it takes between 10 and 20 years for HPV infection to develop into abnormal cervical cells, and then on into cervical cancer. As cervical cancer develops so slowly, it is highly unlikely that women over 64 who have been regularly screened will go on to develop the disease.
If a woman’s final 3 screening tests in the 15 years running up to turning 65 have had normal results, then she won’t receive any further invitations. Anyone who has had an abnormal screening result in that time will continue to be invited until they either have 3 tests showing no abnormal cells, or have a clear (negative) HPV test.
If a woman over 64 has never had cervical screening, or hasn’t had screening since she was 50, then she is entitled to be screened. An appointment can be made with her local GP practice.
Remaining aware of symptoms
No screening test is 100 percent reliable. This means that women should remain aware of any symptoms, and speak to their GP about any concerns. The following symptoms should always be checked out:
- abnormal vaginal bleeding after sex, in between periods, or after the menopause
- pain or discomfort during sex
- abnormal vaginal discharge
You can find more information about cervical screening on NHS Choices.
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