Every woman aged 25 to 65 should be having cervical cytology tests. It is every 3 years till age 50 and then every 5 years.
Since May 2019 the first test performed in the laboratory is a test for Human Papilloma Virus particular types described as high risk. These are the types associated with 95% of cervical cancers. If the test is negative then the woman will be informed and her next test will be according to routine follow up ie 3 or 5 years later.
If the HPV test for HR is positive then further testing is undertaken to see if the cells are normal and if there is any abnormality even a very minor abnormality then the woman is referred for colposcopy. This involves a more detailed examination of the cervix using a colposcope which allows magnification. As for the cervical cytology test a speculum is inserted to give a view of the cervix. The liquid is applied to identify any abnormality and a sample (biopsy) may be taken. If there is a biopsy then there will be some bleeding.
If the biopsy shows a more serious change in the cervix a bigger sample is taken after inserting local anaesthetic. This is also done using the colposcope for vision. This is an LLETZ procedure which generally removes areas of concern. Follow up is usually 6 months later when another test for HPV is performed and often found to be negative. Further follow up depends on that result with closer surveillance required if the HPV is still positive.