Cervical screening is one of the best tools we have for preventing cervical cancer. By finding changes in the cervix early — before they ever become cancer — regular screening prevents up to 75% of cervical cancers.1 This guide explains how screening works, when you should have it in Sri Lanka, and how the HPV vaccine adds a second layer of protection.

Why screening works: it's really about HPV

Almost all cervical cancer is caused by long-lasting infection with certain high-risk types of human papillomavirus (HPV), a very common virus.1 Most HPV infections clear on their own, but sometimes they linger and slowly change the cells of the cervix. Screening catches those changes early, when they are easy to treat.

There are two ways of testing:

  • The Pap smear (cytology) looks at the cervical cells under a microscope for any changes. This is the standard test in most facilities in Sri Lanka.
  • The HPV test checks the same sample for high-risk HPV first. It is more sensitive, and is the direction cervical screening is moving worldwide. HPV testing is now available in some centres in Sri Lanka, particularly in the western provinces.

Both use the same simple sample-taking procedure — so from your point of view, the appointment feels the same.

What the test involves

A cervical screening test is quick and usually only mildly uncomfortable:

  1. You lie back on an examination couch, with your feet supported.
  2. The doctor gently places a smooth instrument (a speculum) to see the cervix.
  3. A small soft brush collects a sample of cells in a few seconds.
  4. The sample goes to the laboratory for testing.

It's normal to feel a little anxious or self-conscious — please tell your doctor or nurse, who will take it gently and talk you through each step.

When should you be screened?

In Sri Lanka, women are invited for cervical screening at age 35 and again at age 45 through the Well Woman Clinic programme. If you have particular risk factors — such as a weakened immune system or a strong family history — your doctor may suggest checking more often, so it is always worth discussing your own situation.

Screening is for anyone who has a cervix, and it is still important even if you have had the HPV vaccine, because the vaccine does not cover every cancer-causing type.

Understanding your results

Results usually come back as:

  • Normal (negative) — continue with routine screening at the recommended time.
  • Inconclusive — a repeat test may be needed.
  • Abnormal (positive) — this does not mean you have cancer. It means some cell changes were found, and a closer look is needed — usually a colposcopy (a magnified examination of the cervix) and sometimes a small biopsy. Any changes found can often be treated simply, long before cancer could develop.

Try not to be alarmed by an abnormal result — most are minor, and finding them is exactly what screening is for.

The HPV vaccine: prevention before it starts

The HPV vaccine protects against the main cancer-causing types of the virus, and is most effective when given before any exposure. In Sri Lanka, the vaccine has been part of the National Immunisation Programme since 2017. It is given to grade 6 schoolgirls (on completion of 10 years of age), as two doses of a vaccine that protects against four HPV types (6, 11, 16 and 18).2

Together, the vaccine and regular screening are a powerful combination — one prevents many infections, the other catches anything that slips through.

The takeaway

Cervical cancer is one of the most preventable cancers there is. A quick screening test at 35 and 45, the HPV vaccine for schoolgirls, and prompt follow-up of any abnormal result together prevent the great majority of cases. If you are due for screening — or simply unsure — please book with us at Sugabi Clinic. A few minutes now can protect you for years to come.

References

  1. Cancer Research UK. Cervical screening [Internet]. London: Cancer Research UK; [cited 2026 Jul 21]. Available from: https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/screening/about
  2. Epidemiology Unit, Ministry of Health, Sri Lanka. Human Papilloma Virus (HPV) vaccination [Internet]. Colombo: Epidemiology Unit; [cited 2026 Jul 21]. Available from: https://www.epid.gov.lk/
  3. NHS. Cervical screening [Internet]. London: NHS; [cited 2026 Jul 21]. Available from: https://www.nhs.uk/conditions/cervical-screening/