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Cervical screening aged 24 or under

In the UK, you are invited for cervical screening (a smear test) from age 25 until age 64. Cervical screening is not recommended for anyone under 25 years old.

You may get your first invite up to 6 months before you turn 25 – if you do, you don’t have to wait to book an appointment.

Why does cervical screening start at 25?

Cervical screening doesn’t reduce new cases of cervical cancer diagnoses in under-25s

Cervical cancer is very rare in under-25s. In the UK, about 92 out of 3,207 people diagnosed with cervical cancer are under the age of 25 – less than 3% of cases.

Cervical screening hasn’t been shown to reduce the number of cases of cervical cancer in people under the age of 25. We know this because in countries where cervical screening starts at 20 years old, the number of people under 25 diagnosed with cervical cancer is not significantly different than in countries that start screening at 25 years old.

The number of cases of under-25s diagnosed with cervical cancer is likely to fall even further over the next 10 years thanks to the human papillomavirus (HPV) vaccine.

Read more about the HPV vaccine >

Under-25s may have unnecessary treatment

Research suggests that the risks of offering cervical screening under the age of 25 outweigh the benefits. When you are under 25, it is common to have changes in the cells of your cervix (abnormalities) and these usually go away by themselves.

Read more about HPV and how our bodies usually get rid of it > 

Knowing about these cell changes could lead to treatment when the changes may simply have gone away on their own. It can also lead to anxiety or upset.

There are also potential risks with some treatments, although more research is needed in this area.

What if I have symptoms?

Although cervical cancer is very rare if you are under 25, it is important for all of us to be aware of cervical cancer symptoms, including:

  • vaginal bleeding that is unusual for you (abnormal bleeding) – this is the most common symptom and may happen during or after sex, or in between periods. 
  • vaginal discharge that is unusual for you – it may have a different smell, look or consistency (for example, it may be thicker)
  • pain or discomfort during sex
  • unexplained lower back pain that lasts a long time.

Remember, things other than cervical cancer could cause all of these symptoms. For example, abnormal vaginal bleeding is very common and can happen for lots of different reasons that are not linked to cancer, including:

  • cervical ectropion (a normal change, sometimes called an ectropion)
  • hormonal changes because of the combined contraceptive pill
  • benign cervical polyps
  • sexually transmitted infections (STIs), such as chlamydia.

Read more about the symptoms of cervical cancer > 

What should I do if I have symptoms?

If you have any symptoms, don’t ignore them! It is important to see your doctor or nurse as soon as possible. Remember it is unlikely to be cervical cancer, but it’s still very important to get it checked out.

The NHS has guidelines for doctors and nurses to support young women and people with a cervix aged 20 to 24. It says you should be offered a pelvic examination by a doctor or nurse if:

  • you are bleeding after sex
  • you are bleeding in between your usual periods.

The guidelines explain the types of questions that doctors and nurses should ask to find out whether the symptoms could be related to cervical cancer.

Download and read Clinical Practice Guidance for the Assessment of Young Women aged 20-24 with Abnormal Vaginal Bleeding (2010) >

If you think it would help, you could print it off and take it your doctor or nurse, or show it to them on your phone or tablet.

Some people find it embarrassing to talk about gynaecological problems. If you feel like this, you are not alone. But remember your doctor or nurse talk about these things all the time, so won’t be embarrassed. If you want, you can take someone you trust with you for support during your appointment.

More information and support

If you have symptoms you are worried about or have heard stories about a young person getting cervical cancer, you may feel very anxious about not being able to have cervical screening. Remember, there is support in place if you do have symptoms and your doctor or nurse should be able to offer the right help and guidance.

If you just want to talk to someone about cervical screening or symptoms, you can call our Helpline on 0808 802 8000 or join our online forum.

Date last updated: 
23 Oct 2018
Date due for review: 
23 Oct 2021

Have a question? Need to talk?

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