Why have smear tests changed from every three years to every five years in Wales?


On 1 January Public Health Wales (PHW) changed cervical screening to every five years instead of every three years for people with cervical cancer aged 25 to 49.


The change will only affect people whose smears came back HPV positive.

Although the change caused concern for many, especially those who had not received the HPV vaccine, since 2008 national vaccination was introduced only for girls aged 12–13.


Due to fears of further deaths from cervical cancer, a petition was launched immediately to return to screening every three years, and Received over 900.00 signatures,

One woman told WellsOnline how she would have been diagnosed with cervical cancer if she hadn’t been seen within three years of her first smear, read her story here.

Public Health Wales quickly responded to this response on social media.


In a tweet, it wrote: “We’re sorry. We haven’t done enough to explain the changes in cervical screening and there is concern.

“We are working to clarify this and more information will be available today and as soon as possible in the coming days.”

The PHW explained how the test is now more effective in identifying people at risk, and therefore, the change is safer to implement with larger gaps between screenings.


Heather Lewis, Public Health Adviser for Cervical Screening Wales, said: “The HPV test we use now in Wales is more effective at identifying people who are at high risk of developing cell changes. that can cause cervical cancer.

“The evidence shows that it is therefore safe to extend the time between cervical screening tests for people who do not have HPV identified.”

Dr. Sharon Hillier, director of the Screening Division, explained the changes in more detail in a video shared by PHW.

She explained how the changes are “current UK recommendations” that have been put forward by the UK National Screening Committee, an independent scientific committee that advises UK governments and the NHS.

These recommendations were taken into account and then approved by the Welsh Government and the Screening Committee, which led to the implementation of Public Health Wales.

Dr Hillier stressed: “This is because the evidence base suggests it is safe to do so.

“This change is not a cost-saving exercise, it is to bring it in line with current UK NSC recommendations.

“We do not expect that this will change the number of women we raise who are at increased risk of cervical cancer.

“We will be referring women to colposcopy services in equal numbers.”

He added that people who are found to be HPV positive will be followed more often than the five-year recommendation.

This change also does not change the date of someone’s next planned cervical screening, only that after that screening, if they are found to be HPV negative, they will be invited again in five years’ time.

Dr Hillier added the importance of attending the screening when invited to do so.

Read more: Find out our latest health stories here

What is the purpose of a smear test?

Cervical screening, more commonly known as a “smear test,” does not test for cancer, although the test can detect cancer earlier. The earlier cervical cancer is detected, the easier it is to treat.

The smear test has three purposes.

  • By picking up cell changes before they become cancerous to reduce the number of cases of cervical cancer (incidence)

  • Preventing cancer from developing, or raising it at an early stage, to reduce the number of deaths from cervical cancer (death)

  • Preventing cancer from developing, or raising it at an early stage when it is much easier to treat, to reduce the health (morbidity) effect of cancer or cancer treatment

What does HPV positive mean?

If you are marked as HPV positive, it means that human papillomavirus (HPV) has been found in your sample.

HPV is not cancerous, although in some people it can cause abnormal changes in cells that can sometimes turn into cancer.

After that there are two different routes.

For someone who is HPV positive, with no abnormal cells, they will be invited back for another smear about a year’s time.

For someone who is HPV positive and has abnormal cells, you will be referred for a colposcopy.

What is a Colposcopy?

A colposcopy is a simple procedure used to get a better look at a person’s cervix.

For the procedure, a speculum is inserted into the vagina and gently opened.

A microscope with light is then used to look at your cervix – you can ask a specialist nurse or doctor to look at it on a monitor.

The microscope does not touch or enter your body.

If deemed necessary, a small biopsy may be removed for closer examination in a laboratory. This can be uncomfortable for some people.

From there, your advisor will contact you regarding your results.

Your colposcopy and/or biopsy will result in either:

  • Normal – four out of 10 people have no abnormal cells and are advised to continue attending cervical screening as usual
  • abnormal – about six out of 10 people have abnormal cells in their cervix and may need treatment to remove them

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