My smear test always comes around in mid-December, so I’ve come to associate it with Christmas.
Once the presents are wrapped and the travel plans are made, I pop into my local GP, put my legs in the stirrups and take deep breaths in and out.
In many ways it’s like a Christmas present from the NHS. Some people bring gold, some myrrh. The NHS? A screen of my cervix to check whether everything is healthy and in working order.
And let’s be honest, what better gift is there than good health?
While the test itself cannot protect you against any issues that may arise with your cervix, it can give you a pretty good idea of the lay of the land.
It can also identify the presence of the Human Pamplona Virus (HPV), a group of viruses that can be sexually transmitted, some of which can cause cancer of the cervix if left without medical intervention.
Yet knowing all of this, I still bloody hate having my smear test done.
Logically, I’m able to see it as a test that could help me to stay safe and prevent me from dying of cervical cancer – a disease that has tragically robbed thousands of women and people with wombs of their lives well before their time.
It’s still something I dread in the lead-up though, something I force myself to go to and something I grit my teeth all the way through.
Then every time the test is over, I wonder why on earth I worried so much.
I, like many other people, am squeamish when it comes to anything to do with my vagina. Given that the cervix rests at the top of the vagina, acting as a protective layer between it and the rest of the uterus — and that there’s literally no other way to access it other than via the vagina — you can see where the problem lies.
I know I’m not alone in my squeamishness; it’s the product of growing up in a society where genitalia and reproductive organs relating to [cis] women are rarely seen or heard in general conversation or public discourse.
This is compounded by a fundamental lack of basic education for all genders around vaginas and how to look after them.
The resultant effect is a pervasive sense of shame that often prevents us from speaking openly about our reproductive health and anything related to it. And that’s before you even take into account the weighty stigma associated with having a sexually transmitted infection, such as HPV.
I wish that having a smear felt as normal as having your temperature checked or having a blood test — but I’m not quite there yet.
The NHS website is now encouraging people to contact their GPs to schedule their cervical screenings
A deeply rooted self-consciousness that afflicts me and many of those with a vagina means I’m overcome with nerves and concern whenever I find myself in the position of being on the receiving end of any sort of gynaecological exam or procedure.
Luckily for me, the nurses and doctors are always incredibly kind and patient, and it’s over much more quickly than I anticipate.
When it comes to fear of the smear, I know I’m not the only one because it’s a test that is chronically underutilised by the population en masse.
First introduced in the UK in 1964, uptake — particularly in lower-age categories and in ‘deprived populations and those with high proportions of ethnic minority communities’ — has been consistently falling in recent years, according to Cancer Research UK.
This is before the impact of the pandemic this year has been taken into account. Research published recently by King’s College London suggests that a large number of women were not able to attend their smear tests during the first wave of the pandemic.
The university modelled two scenarios: the first one looked at what would happen if all those that were eligible had their tests delayed by six months to allow for the NHS to catch up on those missed; the second looked at what would happen if the group that had missed their tests skipped this one and had their next as usual.
In both cases the result was the same: 630 missed diagnoses of cervical cancer.
Because of a delay in testing, those people who may have slipped through the cracks or not been tested until later could mean a failure to pick up HPV cells before they turn into cancer. It’s scary to think how many lives this could impact.
Between April and June, cervical smear tests were halted altogether. Since June, the NHS has been sending out invitations to those who missed their appointments. And while the NHS assures ‘every effort’ has been made to capture all of those whose tests were disrupted by the pandemic, it is as yet unclear what the percentage uptake has been.
The NHS website is now encouraging people to contact their GPs to schedule their cervical screenings.
So schedule yours, and when that’s done, call every other person you know with a vagina and make sure they’ve done it, too.
We need to get better at talking about this, because it’s the only way to break down the shame that so often stops people from scheduling and attending their tests. It is a safe, quick and relatively easy procedure, and one that could save your life.
In a year when so much seems out of our control, please don’t let missing a smear test be the thing standing between you and the good health that you — and all of us — deserve.
Do you have a story you’d like to share? Get in touch by emailing jess.austin@metro.co.uk
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