Cervical and gynaecological cell testing (cytology) (Cervical and gynaecological cytopathology)

This guide explains what happens to the cells collected during cervical screening (a smear), how a specialist examines them, and what your result letter means.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Cervical screening tests your sample for high-risk HPV first, and only examines the cells under the microscope if HPV is found.
It looks for cell changes that could lead to cervical cancer in future — it is not a test for cancer itself, and does not check for womb or ovarian cancer.
Screening lowers the risk of cervical cancer a lot but cannot remove it entirely, so attend when invited and report unusual symptoms even between screens.
Results usually come by letter within about 2 weeks; an HPV-positive result with cell changes leads to a closer look called colposcopy.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeLaboratory analysis of cells from a screening sample (not a procedure you have done to you)

AnaestheticNot applicable — the sample is already taken at your screening appointment

How long it takesLab testing and reporting usually take a couple of weeks

Hospital stayNot applicable

Time off workUsually none

When you'll see resultsUsually by letter within about 2 weeks

On the NHS?Part of the free NHS Cervical Screening Programme; also offered privately

A general guide. Your specialist will give you advice for your situation.

Best fit

Detects high-risk HPV and cell changes early, often before any symptoms.

Pause if

Cervical screening is not the right test if you have symptoms such as unusual bleeding — symptoms need a separate assessment, not a screening test.

Main recovery point

The sample is taken and sent to the laboratory. You can usually go straight back to your normal day; some people notice light spotting afterwards.

Good aftercare

A clear result letter that explains what was found and what to do next.

At your appointment

The sample is taken and sent to the laboratory. You can usually go straight back to your normal day; some people...

First days

The laboratory tests your sample for high-risk HPV, and examines the cells only if HPV is found.

Around 2 weeks

Your result is usually sent to you by letter, and to your GP.

If HPV is found with cell changes

You are referred for colposcopy, a closer look at the cervix, usually within a few weeks. Most people who have...

Medical line illustration of cervical screening and colposcopy assessment for Cervical and gynaecological cell testing (cytology). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is cervical and gynaecological cytology?

Cytology means looking at individual cells under a microscope. In cervical screening, a sample of cells is gently collected from the cervix (the neck of the womb) at your screening appointment. Cervical and gynaecological cytology is what happens next: the cells are examined in a laboratory and a report is produced.

You do not have anything extra done to you for this. The sample has already been taken. This guide is about what happens to your sample and what your result letter means.

In the NHS Cervical Screening Programme, the sample is first tested for high-risk human papillomavirus (HPV), the virus that causes nearly all cervical cell changes. Only if high-risk HPV is found are the cells then examined under the microscope (cytology) to look for changes. This is called HPV primary screening.

Cervical screening checks for changes that could, over time, lead to cervical cancer — it is not a test for cancer itself, and it does not check for other gynaecological cancers such as womb or ovarian cancer. It greatly reduces the risk of cervical cancer but cannot remove it completely, because no screening test is perfect.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

HPV test (done first)

The sample is tested for high-risk HPV. If none is found, the cells are not examined and you return to routine screening. This is the main change brought in by HPV primary screening.

Cytology (cell examination)

If high-risk HPV is found, the cells are examined under the microscope to check for changes. The degree of change is described using terms such as borderline, low-grade or high-grade dyskaryosis.

Borderline or low-grade changes

Mild changes in the cells. Combined with a positive HPV test, these usually lead to referral for a closer look (colposcopy), as they can sometimes settle on their own or sometimes need treatment.

High-grade changes

More marked cell changes. With a positive HPV test, these lead to colposcopy, where a tissue sample (biopsy) and, if needed, treatment can be arranged.

Inadequate (insufficient) sample

Sometimes there are not enough suitable cells to give a clear result. You will usually be asked to come back for a repeat sample, often after about three months.

What your result usually means

Result	What usually happens next
HPV not found	Routine recall — next screening as normal
HPV found, no cell changes	Repeat screening in about 12 months
HPV found, cell changes	Referral to colposcopy for a closer look
Inadequate sample	Repeat sample, usually after about 3 months

This is a general guide only. Your letter and your clinician will tell you exactly what your result means and what to do.

Preparing for your test

There is nothing extra to prepare for the testing itself — the sample is taken at your screening appointment.
Try to book your screening when you are not having a period, as blood can affect the sample.
Tell the sample-taker about any unusual symptoms, such as bleeding between periods, after sex or after the menopause, as screening is not the right test for symptoms.
If you have had previous abnormal results or treatment, mention this, as it may affect your follow-up.
Note how and when you will receive your result (usually a letter within about 2 weeks).
Keep attending when invited, even if you feel well and have had the HPV vaccine.

What happens

At your screening appointment, a small brush is used to collect cells from the cervix, which are placed into a pot of liquid and sent to the laboratory.

In the laboratory the sample is first tested for high-risk HPV. If no high-risk HPV is found, the cells are not examined further and you are returned to routine screening. If high-risk HPV is found, a specialist (a biomedical scientist or cytopathologist) examines the cells under the microscope to look for any changes.

The laboratory then produces a result, which is sent to you, usually by letter, and to your GP. If a closer look is needed, you are referred for colposcopy.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Cervical screening is not the right test if you have symptoms such as unusual bleeding — symptoms need a separate assessment, not a screening test.
It does not check for womb, ovarian, vulval or other gynaecological cancers.
It is not designed for those outside the programme's age range or for diagnosing an existing problem.
It cannot give a reliable result from an inadequate sample, which must be repeated.

Delay or rearrange if…

You are having a period, as blood can make the sample harder to read.
You have symptoms that need urgent assessment, which should be dealt with first rather than waiting for routine screening.
You have recently had treatment to the cervix and are within the advised waiting period.
You are pregnant and screening can usually be safely deferred — check with your clinician.

Alternatives to discuss

Following the routine NHS screening interval rather than testing more often.
Prompt assessment by a GP or gynaecologist if you have symptoms.
Colposcopy and biopsy when cell changes need a closer look or a tissue diagnosis.
HPV vaccination to reduce the risk of cell changes, alongside (not instead of) screening.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Detects high-risk HPV and cell changes early, often before any symptoms.
Allows changes to be watched or treated before they could develop into cancer.
Greatly reduces the chance of developing cervical cancer over a lifetime.
A clear, low-risk result can be reassuring and means routine recall.
Helps target colposcopy at the people most likely to benefit from it.
Provides a written record that guides how often you need screening.

Risks & complications

More common

Waiting for the result letter can be worrying.
A 'HPV found' result can be upsetting, even though HPV is very common and usually clears on its own.
An inadequate sample sometimes means you have to come back for a repeat.
Screening does not check for other gynaecological cancers, which can give false reassurance if you have symptoms.

Less common

A result may say cells are abnormal when the cervix is actually normal (a false positive), leading to extra tests.
A result may miss changes that are present (a false negative), which is one reason screening is repeated over time.
Referral to colposcopy and possible biopsy or treatment, with their own discomfort and small risks.

Rare but serious

Treatment of cell changes can, in some people, affect future pregnancies, which should be discussed before treatment.
Very occasionally a sample is lost or has to be repeated for laboratory reasons.

Screening reduces the risk of cervical cancer but cannot remove it entirely, and it is not a test for womb, ovarian or other cancers. If you have symptoms such as bleeding between periods, after sex or after the menopause, do not wait for your next screen — see your GP, because symptoms need a different assessment even if your last screen was normal.

Published figures to discuss

How often a sample is inadequate, or a result is a false positive or false negative, varies with sample quality, the laboratory and the population screened. Liquid-based methods have reduced inadequate samples compared with older techniques, but no screening test is perfect. We avoid quoting precise percentages here; the key points are that screening lowers risk rather than removing it, and that symptoms always need separate assessment.

Figure	Reported range	How to interpret it	Source / confidence
False negative cervical screening	Recognised screening limitation	No screening test is perfect; symptoms such as bleeding after sex still need assessment even after a normal screen.	NHS — Cervical screeningnhs.ukSource-linked context
HPV positive result without cell changes	Common screening scenario	High-risk HPV is common and often clears; follow-up is based on the national screening pathway.	NHS — Cervical screeningnhs.ukSource-linked context
Inadequate sample	Uncommon but expected	A repeat sample may be needed if there are too few cells or technical problems.	Guide sourcesClinical context
Over-treatment anxiety	Common patient concern	Screening finds risk of future cancer, not usually cancer itself; colposcopy clarifies next steps.	NHS — Cervical screeningnhs.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from the testing itself, because the sample has already been taken at your screening appointment. The main thing afterwards is waiting for your result letter and understanding what it means.

At your appointment

The sample is taken and sent to the laboratory. You can usually go straight back to your normal day; some people notice light spotting afterwards.

First days

The laboratory tests your sample for high-risk HPV, and examines the cells only if HPV is found.

Around 2 weeks

Your result is usually sent to you by letter, and to your GP.

If HPV is found with cell changes

You are referred for colposcopy, a closer look at the cervix, usually within a few weeks. Most people who have colposcopy do not have cancer.

If HPV is found with no cell changes

You are usually invited back for a repeat screen in about 12 months to check whether the HPV has cleared.

What's normal — and not a worry

Light spotting for a day or so after the sample is taken.
Feeling anxious while you wait for your result letter.
Being asked to repeat the test after about 3 months if the sample was inadequate.
Being invited back in 12 months if HPV is found but the cells look normal.

Aftercare

Read your result letter carefully and follow the instructions it gives.
If you do not receive a result within a few weeks, contact your GP to check.
Attend any repeat screen or colposcopy appointment you are offered.
Do not ignore symptoms — see your GP about any unusual bleeding or discharge, even with a normal screen.
Keep attending future screening invitations, including after the menopause up to the programme's upper age.
Ask your GP or the colposcopy clinic to explain anything in your letter you do not understand.

Before your test

Booked screening when not on your period
Mentioned any symptoms to the sample-taker
Noted when your result letter should arrive
Kept a record of previous results or treatment
Saved your GP's number to chase results if needed
Diarised any repeat or colposcopy appointment

⚠ Get urgent help if…

Bleeding between periods, after sex, or any bleeding after the menopause
A change in vaginal discharge that is persistent or unusual
Persistent pelvic pain or pain during sex
Unexplained weight loss with gynaecological symptoms
Heavy bleeding or signs of infection after a colposcopy biopsy or treatment
Any symptom that worries you, even if your last screening result was normal

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result clearly tells you whether high-risk HPV was found and, if it was, whether any cell changes were seen and what should happen next. The most common results are reassuring: HPV not found, with a return to routine screening.

A result cannot prove you will never develop cervical cancer, and it does not check for womb, ovarian or other cancers. Screening lowers risk over time rather than removing it, which is why repeat screening matters and why symptoms always need separate assessment. Your letter and your clinician will explain exactly what your result means for you.

How long it lasts

A screening result reflects your sample at the time it was taken. How long it stays useful depends on the result: a clear, HPV-negative result usually means routine recall. The routine timing is not the same across the UK. England, Scotland and Wales currently invite every 5 years for ages 25 to 64 after an HPV-negative result. Northern Ireland currently invites every 3 years at ages 25 to 49 and every 5 years at ages 50 to 64. An HPV-positive or abnormal result means earlier repeat testing or a closer look, wherever you live, so always follow the timing given in your invitation or result letter. Cell changes and HPV status can change over time, so screening is repeated rather than being a one-off.

Related tests, treatments or support

Cervical cytology is closely linked to the HPV test, which is now done first and decides whether the cells are examined. If changes are found, colposcopy and a possible tissue sample (biopsy) follow, and that biopsy is examined by a pathologist. Screening sits alongside the HPV vaccination programme, which reduces the risk of cervical cell changes.

Follow-up & long-term care

Your result is sent to you and your GP. If HPV is found with cell changes you are referred for colposcopy; if HPV is found without changes you are usually re-tested in about 12 months; if no HPV is found you return to routine recall. After two inadequate samples you may also be referred for colposcopy. Your letter will tell you which applies to you.

Attend cervical screening whenever you are invited, up to the programme's upper age.
Keep your contact details up to date with your GP so invitations reach you.
Report unusual symptoms promptly rather than waiting for the next screen.
Follow any earlier recall arranged after an HPV-positive or abnormal result.

Repeat, follow-on and what comes next

An inadequate sample usually needs to be repeated, often after about three months.
An HPV-positive result with normal cells usually means a repeat screen in about 12 months.
Cell changes seen on cytology may be re-checked at colposcopy with a tissue biopsy before any treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A clear result letter that explains what was found and what to do next.
An easy way to ask questions and to chase the result if it does not arrive.
Prompt referral to colposcopy when needed, with clear information about it.
Advice to report symptoms between screens rather than waiting for the next invitation.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether you use the free NHS programme or pay for a private test.
Whether HPV testing, cytology, or both are carried out on the sample.
The clinic or appointment fee for taking the sample privately.
Any follow-up consultation to explain the result.
Onward costs if colposcopy, biopsy or treatment is needed.
Whether a repeat sample is required because the first was inadequate.

Make sure your written quote includes

The fee for the appointment and for taking the sample.
The laboratory fee for HPV testing and/or cytology.
Whether a follow-up consultation to explain results is included.
What happens, and who pays, if the sample is inadequate and must be repeated.
What the pathway is, and any cost, if you are referred for colposcopy.
How and when your result will be given to you and your GP.

On the NHS? Cervical screening is free on the NHS for everyone with a cervix aged 25 to 64. The routine interval differs across the UK: England, Scotland and Wales currently invite every 5 years after an HPV-negative result, while Northern Ireland currently invites every 3 years at ages 25 to 49 and every 5 years at ages 50 to 64. Follow the timing in your invitation or result letter. Private screening exists but should follow the programme's recommended timing rather than replace it.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What exactly does my result mean, and what should happen next?
If HPV was found, when will I be re-tested or seen for colposcopy?
What happens if my result is inadequate or inconclusive?
I have symptoms — is screening the right test, or do I need a different assessment?
If I am referred for colposcopy, what does that involve and what are the risks of any treatment?
How does this result affect when I should next be screened?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my test, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this test not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

What does it mean if HPV is found?

High-risk HPV is very common and usually clears by itself. If it is found, the laboratory then looks at your cells. If the cells are normal you are usually re-tested in about 12 months; if there are changes you are referred for a closer look (colposcopy).

Does a normal result mean I definitely don't have cancer?

No screening test is 100% accurate. A normal result greatly lowers your risk but cannot rule cancer out completely, and screening does not check for womb or ovarian cancer. Always report symptoms such as unusual bleeding to your GP.

Why was my sample 'inadequate'?

Sometimes there are not enough suitable cells to give a clear result. It does not mean something is wrong. You will usually be invited back for a repeat sample, often after about three months.

What is the difference between a smear and cytology?

The 'smear' is the appointment where cells are collected. Cytology is the laboratory examination of those cells under a microscope, which now only happens if high-risk HPV is found in your sample.

Can I have this privately?

Cervical screening is free on the NHS at set intervals. Private screening is available, but it is important to follow the NHS programme's recommended timing and not to over-test, which can lead to unnecessary worry and procedures.

I've had the HPV vaccine — do I still need screening?

Yes. The vaccine protects against most but not all high-risk HPV types, so screening is still recommended for everyone with a cervix when invited.

How often will I be invited, and is it the same across the UK?

Routine cervical screening is offered from age 25 to 64, but the interval is not the same across the UK. In England, Scotland and Wales you are currently invited every 5 years after an HPV-negative result. In Northern Ireland you are currently invited every 3 years between ages 25 and 49, and every 5 years between ages 50 and 64. If high-risk HPV is found or your cells show changes, you will be seen again sooner. Always follow the timing given in your invitation or result letter.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Cervical screening NHS England — Your guide to NHS cervical screening GOV.UK — Cervical screening: understanding test results GOV.UK — The NHS Cervical Screening Programme (NHSCSP) Cancer Research UK — About cervical screening Royal College of Pathologists — What is pathology? NHS — Cervical screening: when you'll be invited NHS inform (Scotland) — Cervical screening Public Health Wales — Cervical screening FAQs nidirect (Northern Ireland) — Cervical screening

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.