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The Cervical smear test — what to expect

Normal, negative or clear smear

A normal, negative or clear result means that when the technician looked at your smear under the microscope the cell structure appeared to be within normal limits. You are at very low risk of developing cervical cancer within the next five years. This result is good news but it does not give you the all clear for ever so it’s important to go for your next scheduled smear test.

Sometimes a normal smear will also show signs of a vaginal infection, such as thrush, or a sexually transmitted infection, such as chlamydia. If this is the case, you will be asked to contact the surgery or clinic for information about treating the infection. This does not change your smear result, but the news that you have both a normal result and an infection may be confusing at first. Your smear result letter may not tell you what type of infection was found, and this may be quite distressing, particularly if you receive the news out of clinic hours and have to wait to speak to your nurse or doctor.

When you speak to your doctor, you may want to ask:

• What is the infection and how did I get it? What are my treatment options?
• Should my sexual partner(s) be checked for the infection?
• What can I do to avoid getting the infection again?

Inadequate or unsatisfactory smear

About 1 in 10 smears need to be taken again because they couldn’t be analysed. This is usually because there were not enough sample cells on the slide, but it may be that:

• the slide was broken
• blood, mucus or an infection in the sample made it too difficult to examine the cells
• the sample may not have been prepared properly

An unsatisfactory or inadequate smear is not your fault. Ask the doctor or nurse why you need to have a repeat smear and when you should have it. If there were signs of an infection, you may need to have treatment first before you schedule another smear.

Cervical ectropion (erosion)

During a smear test, the doctor or nurse may detect cervical ectropion. It sounds worse than it is. Often found in young women, pregnant women and women who are on the pill, cervical ectropion is not a serious condition and has nothing to do with cancer. If you have cervical ectropion, it means that some cells which are usually only found in the cervical canal (see illustration) were found on the cervix itself. You may have no symptoms at all, but it may cause discharge or bleeding after sex and between periods. The condition usually goes away on its own, but if it doesn’t, it can be treated by destroying the out-of-place cells in the same way abnormal cells are treated (see treatments).

Borderline or inflammatory smear

A borderline result means that very slight changes were found in your cervical smear. The cells are not abnormal but they’re not quite normal either. A borderline result is probably not what you were hoping for, but these minor changes usually go back to normal on their own and are nothing to worry about. It may simply be that your cervix was irritated when the smear was taken or that your body was fighting an infection. In any case, you will be asked to return for a repeat smear, usually in 3 to 6 months, to check that the cells have in fact gone back to normal.

If your repeat smear is normal, your doctor will most likely recommend that you go back to regular screening intervals, but you may be advised to have another smear in six months’ time just to be sure the cells have remained normal. If your repeat smear is borderline, you will either be asked to wait a bit longer and have another smear in a few months, or your doctor may suggest further investigations (see colposcopy).

Written by Tamara Beus and published in printed format (2003) by Women's Health

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