About Cervical Screening
Women and people with a cervix aged 25-64, living in England, are screened every five years. If you are 65 or over and have never had a cervical screening (smear) test, then you can ask to have one.
CSAS is responsible for making sure you are sent your invite and results communication at the right time. You can read more about the cervical screening process and how it works at the NHS cervical screening pages.
Can I have a cervical screening (smear) test more often?
In England, people between the ages of 25 and 64 are invited for cervical screening every five years as part of the NHS Cervical Screening Programme (CSP). It normally takes many years for cervical cancer to develop from any cell changes that may happen in the cervix. Screening every five years can pick up these changes before they become cancer.
The only people who are screened more often are:
People who have been seen in a colposcopy clinic, who might need more frequent tests for a period of time
People with HIV are advised to have screening every year, even if no high risk HPV is found
People who have high risk HPV found on their screening test but no cell changes
If you have no high risk HPV found on your screening test, you cannot be screened again any sooner than five years.
I am under 25 and want to have a cervical screening (smear) test. Why can’t I have one?
In England, you will be invited for cervical screening from age 25 until age 64. Cervical screening is not recommended for anyone under 25 years old.
Cervical cancer is very rare in people under the age of 25, and cervical screening hasn’t been shown to reduce cancer cases in this age group. Most cell changes in this age group will go away on their own. Screening individuals under the age of 25 can lead to treatment which may not be necessary.
If you are under 25, you will have been offered the HPV vaccine at school. If you had the vaccine, then you will have a lower chance of having HPV. You will be invited for your cervical screening (smear) test when you are due at 25. It is still important to attend even if you have had the vaccine, as it does not protect against all types of HPV.
Even if you did not have the HPV vaccine, you still do not need a cervical screening (smear) test until the age of 25.
If you have are having any symptoms, such as irregular bleeding, discharge or pain during sex, it is important that you see your doctor.
Your first invitation for screening will be sent when you are 24.5 years old. You can go for screening straight away, you don’t need to wait for your 25th birthday if you have had your invitation letter.
I am over 65, why am I no longer invited for screening?
In England, individuals who are eligible for cervical screening are invited up to the age of 64. The screening programme stops then because individuals who have no HPV (human papillomavirus) at this time are very unlikely to go on to develop cervical cancer in later years.
Although cervical cancer does occur in older individuals, it is often in people who have had no screening, or who have not had enough screening tests in the past. Even if all of your past tests were normal, it is very important that you report any unusual bleeding, discharge or other symptoms to your doctor. This includes:
Bleeding after sex, between periods or after the menopause
New or different vaginal discharge (change in colour, amount or consistency)
Lower tummy or back pains, or pain during sex
If you have never been for a cervical screening (smear) test you can ask at your doctor’s surgery to have one, even if you are over the age of 65.
I’m still being invited for screening despite having had a hysterectomy. Why is this?
Sometimes the Cervical Screening Administration Service (CSAS) has not been made aware that you have had a hysterectomy, so they continue to invite you for screening. Your doctor can inform CSAS about your hysterectomy and they can then stop your screening invitations.
A hysterectomy removes the uterus (womb) and this usually includes the cervix (neck of the womb). This is called a ‘total hysterectomy’. Sometimes the cervix may be left in place, this is called a ‘subtotal hysterectomy’. If you have had a ‘sub-total hysterectomy’, you should continue having cervical screening (smear) tests up to the age of 65 years. Your doctor will be able to tell you what type of hysterectomy you have had.
After a total hysterectomy you would not normally need any further screening tests. However, if a further screening test is needed, your gynaecologist will let you know.
Why did NHS England change routine screening invitation to five years for everyone?
The UK National Screening Committee has recommended that cervical screening programmes invite all people with a cervix, aged between 25 and 64 every five years once they have tested negative for HPV.
Evidence shows that it is safe to extend the time between cervical screening (smear) tests for people who do not have HPV. NHS England made this change from 1st July 2025 bringing England in line with Scotland and Wales.
Human papillomavirus (HPV) is a virus that causes nearly all cases of cervical cancer. This test is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer.
This change applies to people whose next routine screening result shows that they do not have HPV. This means their risk of developing cervical cancer within the next five years is very low.
We will look at the cells if high-risk HPV is found in a cervical screening sample. Follow-up for these individuals may be different depending on their test results.
I am pregnant / just had a baby and received a screening invitation communication. Should I still attend for screening?
You might not need cervical screening if you:
are pregnant
have given birth in the last 6 weeks
If you have received an invitation and aren’t sure that you should be screened, please speak to your GP practice.
It is your choice whether or not to take part in cervical screening. You can opt-out or opt back in at any time.
How to opt-out
Before making your decision, please read the Helping You Decide leaflet and if you have any other questions or concerns about being part of the cervical screening programme please contact your GP Practice.
You will need to send a letter or an Informed Choice form stating you wish to be withdrawn, which must be signed by you (the person withdrawing themselves from the programme).
Write to your GP and complete the Informed Choice form
You can write direct to your GP asking to be taken off their invite list. You can also send a completed copy of the Informed Choice form to your GP and they will submit it for you.
Submit the online form
If you would like to submit the completed Informed Choice form yourself, please use this form:
You will need your NHS number.
Opting back in
If you have previously opted-out of having smear tests but have changed your mind, you can ask your GP to add you back to the invite list at any time.
Further information
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