The ideal time for obtaining a cervical smear is midcycle if the woman is premenopausal; this prevents contamination from menstrual flow and allows for accuracy of results (Higgins [84], WHO [259]). It is not ideal to take a cervical smear if a woman is pregnant or immediately post‐partum as the results obtained can be misleading. The World Health Organization suggests that if a woman is in the target age group and there are concerns about access to screening post‐partum, then a cervical smear should be taken following childbirth after consent is obtained (WHO [259]).

In the UK, 80% of cervical smears are taken in the primary care setting and most are taken by practice nurses. Screening is recommended in the UK for all women between the ages of 25 and 64 years and is an investigation to confirm that the cervix is healthy and there are no abnormal changes to the cells; it is not a test for diagnosing cervical cancer (Higgins [84], NHSCSP [161]). HPV testing was introduced into the NHS cervical screening programme in April 2011. HPV testing does not require any other additional procedures in addition to the regular smear test. In practice, the residual smear sample is used to test for HPV and this is conducted in a laboratory (NHSCSP [159]).

Liquid‐based cytology (LBC) is the established method for cervical smears in Europe and the USA. Other countries may still use the conventional cytology methods, depending on their human, infrastructure and financial resources. The sample used to test for HPV DNA can also be used to test for sexually transmitted diseases such as chlamydia and gonorrhoea (Schuiling and Likis [223]).