In short: An "abnormal" cervical screening result almost never means cancer. In England, your sample is first tested for high-risk human papillomavirus (HPV). If HPV is found, the sample is checked for abnormal cells. Depending on the result, you will either be invited back in a year or referred for a colposcopy, a closer look at the cervix. Most cell changes found this way never become cancer, and those that might can be treated early.

This guide, reviewed by a Ready Health prescribing pharmacist, explains what each cervical screening (smear test) result means and what happens next, based on current NHS guidance.

How does cervical screening work in England now?

Cervical screening, often still called a smear test, is not a test for cancer. It aims to find high-risk HPV, the virus responsible for nearly all cervical cancers, and any early cell changes it may have caused, so they can be monitored or treated before cancer develops.

You are invited from around age 25 up to 64 if you have a cervix and are registered with a GP.
If HPV is not found, you are invited again in five years.
The laboratory only looks for abnormal cells if HPV is found. This is called HPV primary screening.
From 2026, the NHS in England has begun offering home self-sampling kits by invitation to some people aged 30 to 65 who have not attended screening.

What do the different smear test results mean?

Result	What it means	What usually happens next
HPV not found (negative)	Your risk of cervical cancer is very low	Routine invitation in five years
HPV found, no abnormal cells	You have the virus but no cell changes were seen	Repeat screening in one year; if HPV is still present after two years, you are referred for colposcopy
HPV found, abnormal cells	Cell changes were seen; these are usually not cancer	Referral for colposcopy
Inadequate (unclear) result	The sample could not be read properly	Repeat test in about three months

What causes abnormal cervical cells?

Almost all abnormal results are linked to high-risk HPV, a very common virus passed on through close skin-to-skin sexual contact. Most people will have HPV at some point, and the immune system usually clears it without any problems. In a small number of people the infection persists and, over many years, can cause cells to change.

Cell changes are sometimes described by grade. Older letters may mention "dyskaryosis" (borderline, low-grade or high-grade). After colposcopy or biopsy, you may see the term CIN (cervical intraepithelial neoplasia) graded 1 to 3. CIN1 often clears by itself; CIN2 and CIN3 are more likely to be treated. None of these are cancer.

What happens at a colposcopy?

A colposcopy is usually done in a hospital clinic. It feels similar to a smear test but takes a little longer.

A speculum is used and the cervix is viewed through a magnifying microscope (colposcope) that stays outside the body.
Liquids may be applied to show up abnormal areas.
A small sample (biopsy) may be taken for testing.
If clearly abnormal cells are seen, they may be removed at the same visit, most commonly with LLETZ (large loop excision of the transformation zone) under local anaesthetic.

Cell changes develop slowly, so they will not usually get worse while you wait for your appointment. Treatment is very effective, and you will have a follow-up test, usually around six months later, to check HPV has cleared.

When should I see a doctor regardless of my screening result?

Screening is for people without symptoms. Contact your GP whatever your last result if you have bleeding between periods, after sex or after the menopause, unusual vaginal discharge, or pain during sex or in the lower back or pelvis that does not settle.

Frequently asked questions

Does an abnormal smear mean I have cancer?

Very rarely. Most results showing HPV or abnormal cells lead to monitoring or simple treatment, which is how screening prevents cancer.

Does HPV mean my partner has been unfaithful?

No. HPV can stay inactive in the body for many years, so it is usually impossible to know when or from whom it was caught.

Can I still get pregnant after LLETZ?

Most people can. Treatment can slightly increase the chance of premature birth in a future pregnancy, so tell your midwife if you have had it.

I had the HPV vaccine. Do I still need screening?

Yes. The vaccine does not protect against every high-risk HPV type, so you should still attend when invited.

Can I have a smear privately?

Yes. A private test can suit people who have missed an invitation or want a test at a convenient time. It does not replace the NHS programme, so keep attending NHS screening when invited and share any results with your GP.

Key takeaways

Cervical screening in England tests for high-risk HPV first; cells are only checked if HPV is found.
Most people with HPV clear it naturally; abnormal cells are not cancer.
Colposcopy is a straightforward follow-up test, and any treatment needed is usually quick.
Symptoms such as unusual bleeding should be checked by a GP, even after a normal result.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If you would like a cervical screening test at a time that suits you, or advice about your results, book a private cervical screening appointment at Ready Health in Standish, Wigan.