24 Nov 2016
How often should you have a smear?
Q: How often should you have a smear? Can you have a smear when pregnant? When in your cycle should you have smear?
A: First of all, I just want to make sure you know what a smear is as I’ve had quite a few patients who were unsure what a smear actually does. A smear test only checks for cytology of the cervix, this does not include your ovaries or uterus and it does not test for infections. Cytology refers to the study of cells; the smear is sent to a lab to be looked at under a microscope to see what types of cells are present and whether or not these are normal. The results usually come back in the form of CIN1,2 or 3 or inadequate. Inadequate does not mean your cervix is inadequate (I have had a patient ask this!), it just means you may have been on your period or the person doing the smear didn’t get quite enough cells on the stick etc… You will need to have a repeat test.
CIN 1 does not mean you have cancer! This means that some of the cells are different to other cells. This is very common when you are younger as your cells are still developing. This is part of the reason for having lower age limit. These cells are unlikely to turn into anything serious but your doctor will want to repeat the test in 6 months time. If this shows CIN again then you will need to go to see a gynaecologist.
CIN 2 does not mean you have cancer! This means that there are some cells that are very different to your normal cells and these are unlikely to change back to normal. You will need to go for an exam at the gynaecologist’s and they may remove a small area of your cervix for further testing (biopsy).
CIN 3 does not mean you have cancer! However, this does mean that you have some very abnormal cells that will likely become cancerous if left untreated. You will need to see a gynaecologist who will likely remove some of your cervix which has the abnormal cells to prevent them from spreading.
OK so now to actually answer your questions:
You should have a smear every 3-5 years between the ages of 25-60 if you are sexually active. Obviously this will be more frequently if you have been asked to come back because of any of the above smear results. Also, you should have a smear test regardless of your sexuality.
If your routine smear is due whilst pregnant postpone it until 3 months after the baby is born. However, if you need to have smear because of previously abnormal results or are behind on your schedule you may need to have a smear whilst pregnant. This will not affect your pregnancy.
Finally, when in your cycle should you have a smear? The best time to have a smear is mid-cycle (so 14 days after you started your period). This gives best results and is most comfortable for you.