In England, NHS cervical screening is offered to women and people with a cervix aged 25 to 64. If you are younger or older than that, you will not be invited, and GP surgeries generally will not offer a routine smear test.
You can have a smear test privately at any age, but that does not mean it is always the right test. This guide explains why the NHS uses those age limits, when private screening outside them is reasonable, and when a consultation is what you actually need.
Who the NHS screens, and how often
- Ages 25 to 64: invited every five years if your last test was HPV negative. In England the interval for ages 25 to 49 changed from three years to five years in July 2025.
- HPV found, cells normal: invited back after 12 months instead of five years.
- Under 25: first invitation sent shortly before your 25th birthday, but no routine screening before that.
- 65 and over: screening usually stops, unless a recent result was abnormal.
Scotland and Wales also screen from 25 to 64. Northern Ireland has its own schedule.
Why there is no NHS screening under 25
The age of 25 was chosen deliberately, not to save money. Cervical cancer is rare in women under 25. HPV infection and minor cell changes, on the other hand, are very common at that age and nearly always clear up on their own.
Screening younger women finds many of those harmless, temporary changes. Some then lead to treatment of the cervix, which carries a small risk of problems in later pregnancy, without preventing many cancers. The HPV vaccine, offered in schools since 2008, has also greatly reduced the high-risk HPV types in younger age groups.
Can I have a private smear test under 25?
Yes. Private screening is available below 25, and some people have good reasons for wanting it, such as:
- Moving to the UK from a country where screening starts earlier, often at 21 or soon after becoming sexually active
- Wanting to continue a routine of regular testing they had abroad
- Having had previous abnormal results that were not followed up
- Being unvaccinated and wanting reassurance
Before taking the sample, Dr Mermigka will talk through whether screening makes sense for you, including the chance of a positive HPV result that would very probably clear on its own. If the honest answer is that a test is unlikely to help, she will say so.
Symptoms are different: book a consultation, not a smear
A smear test is a screening test for people without symptoms. It is not designed to investigate a problem. Whatever your age, these symptoms need a gynaecology consultation with an examination:
- Bleeding after sex
- Bleeding between periods, or any bleeding after the menopause
- Unusual or persistent vaginal discharge
- Pain during sex or persistent pelvic pain
This matters most under 25, when people are sometimes told they are too young for a smear and assume their symptoms can wait. They should not wait. The examination is what is needed, not a screening test.
Why NHS screening stops at 64
If you have had regular screening with normal results up to your mid-60s, your risk of developing cervical cancer afterwards is very low, so the NHS stops inviting you. You will still be invited after 64 if one of your last tests was abnormal, until it has been followed up.
If you are 65 or over and have never had a smear test, you can ask your GP for one on the NHS.
Can I have a smear test over 64?
Yes, privately. It can be a reasonable choice if:
- You missed screening in your 50s or early 60s, or your history is incomplete
- You were screened abroad and are not sure your results were normal
- You have a new partner and want reassurance
- You simply want to keep checking for peace of mind
After the menopause, the cervix and vaginal tissues become thinner and drier. This can make the test more uncomfortable and occasionally makes the sample harder to read. A smaller speculum helps, and sometimes a short course of vaginal oestrogen beforehand is suggested. Let us know when you book if you have found smears difficult.
What if I have had a hysterectomy?
It depends on what was removed. If your cervix was removed (a total hysterectomy) for a non-cancerous reason, you no longer need screening. If your cervix was left in place (a subtotal hysterectomy), you still need screening. If you are not sure which you had, your operation note or GP record will say.
Smear tests at AristoGP
Smear tests are taken by consultant gynaecologist Dr Anastasia Mermigka at 1-5 Portpool Lane, London EC1N 7UU. An HPV smear test (UK method) is £150, with cytology added free if HPV is found. HPV and Pap reported together is £230. Results usually take 2 to 5 days. You can read more on our smear test page or see what a private smear test costs in the UK.
Frequently asked questions
Can I get a smear test at 21 in the UK?
Not routinely on the NHS, which starts screening at 25. You can have one privately, and a consultant can discuss whether it is likely to help you. If you have symptoms such as bleeding after sex, you need an examination at any age.
Why is cervical screening not offered under 25?
Cervical cancer is rare under 25, while HPV and minor cell changes are common and usually clear on their own. Screening younger women leads to unnecessary treatment without preventing many cancers.
Do I need a smear test after 65?
Not usually, if your recent results were normal. You will still be invited if a recent test was abnormal, and if you have never been screened you can ask for a test.
Can I pay for a smear test if I am over 65?
Yes. Private screening is available at any age. At AristoGP an HPV smear test is £150.
Do I need a smear test after a hysterectomy?
Not if your cervix was removed for a non-cancerous reason. If your cervix was left in place, you still need screening.
Related care and reading
Book a smear test or a consultation.