Research and analysis

GP attendances – screening tests

Updated 25 May 2022

Applies to England

This is one of a series of summaries produced for the campaign, each focusing on a different evaluation measure (referred to as a metric) which reflects an important point in the patient pathway. These metrics should not be considered in isolation. Please refer to the considerations when interpreting these results.

Main findings

The first national ‘Cervical Screening Saves Lives’ campaign appears to have had an impact on the number of women attending their GP practice to undergo a cervical screening test. During the campaign there was an increase from 11.4 to 13.7 visits per practice per week, compared to the previous year.

In women eligible for cervical screening, there was an increase of 18.7% in GP attendances per practice in women aged 25 to 49 years and a 25.2% increase in women aged 50 to 64 years.

The campaign may also have had an impact on both the number of cervical screening test non-attenders^{[footnote 1]} and the number of women who attend their GP practice to undergo cervical screening but are not eligible^{[footnote 2]}.

Background

This metric considers whether the first national ‘Cervical Screening Saves Lives’ campaign had an impact on the number of women attending their GP practice to undergo a cervical screening test, the number of cervical screening test non-attenders^{[footnote 1]}, and the number of women who attend their GP practice to undergo cervical screening but who are not eligible^{[footnote 2]}.

Methods

Data on GP attendances for cervical screening tests were sourced from The Health Improvement Network (THIN) database for the period 6 November 2017 to 27 October 2019^{[footnote 3]}. The data was grouped into weekly attendances and adjusted to account for bank holidays. Information on the number of GP practices submitting data each week (which decreased from 158 to 93 practices over the period considered^{[footnote 4]}) was also extracted, to enable the calculation of the average number of attendances per practice per week.

Analysis considered 3 periods: a 12 week pre-campaign period (10 December 2018 to 3 March 2019), a 10 week analysis period (4 March 2019 to 12 May 2019) and a 12 week post-campaign period (13 May 2019 to 4 August 2019). It compared the average number of GP attendances per practice per week during these periods with the same periods one year earlier, in 2017 to 2018. Analyses were broken down by age group into women of screening age (25 to 49 and 50 to 64 years) and non-screening age (less than 25 years and 65 years and over).

Results

GP attendances for a cervical screening test

Figure 1 provides the trends in the average number of GP attendances per practice per week. The average number of GP attendances per practice per week for cervical screening tests shows variability before, during and after the campaign. The increase around January every year coincides with the annual Cervical Cancer Prevention Week campaign run by Jo’s Cervical Cancer Trust.

Figure 1: Average number of GP attendances, per practice per week, for cervical screening tests, 6 November 2017 to 27 October 2019, England, All ages.

Considering all ages together, the number of GP attendances was significantly higher in the pre-campaign period compared to the same period one year earlier, with a 13.2% increase (p<0.001). There was a statistically significant 20.2% increase in the number of GP attendances for cervical screening tests during the analysis period compared to the same period in 2018, from 11.4 to 13.7 visits per practice per week (p<0.001).

Figure 2 provides the trends in the average number of GP attendances per practice per week by age group. For women of screening age, the average number of GP attendances per practice per week for cervical screening tests shows variability before, during and after the campaign. Similarly, for women aged less than 25 years there was variability, however this was less extreme. In contrast, for women aged 65 or older the average number of GP attendance remained stable.

Figure 2: Average number of GP attendances by age group, per practice per week, for cervical screening tests, 6 November 2017 to 27 October 2019, England.

Considering women of screening age:

• women aged 25 to 49 years had a significant 18.7% increase in the number of GP attendances for cervical screening tests during the analysis period, from 8.3 to 9.9 attendances per practice per week comparing 2018 to 2019 (p<0.001)
• women aged 50 to 64 years had a significant 25.2% increase during the analysis period, from 2.5 to 3.1 attendances per practice per week (p<0.001)
• in the pre-campaign period the number of GP attendances for cervical screening tests was also significantly higher, increasing by 11.8% (p<0.001) and 19.4% (p<0.001) comparing 2018 to 2019 (p<0.001) for women aged 25 to 49 years and 50 to 64 years, respectively

The number of attendances per practice per week for women less than 25 years increased from 0.54 in 2018 to 0.64 in 2019 with (p<0.001). For women aged 65 years and over, this increased from 0.03 in 2018 to 0.05 in 2019 (p value=0.033).

Cervical screening non-attenders

In both the pre-campaign and analysis periods, the number of cervical screening non-attenders decreased significantly (p<0.001), by 35.8% (0.59 non-attenders per practice per week to 0.38) and 34.4% (0.41 non-attenders per practice per week to 0.27) respectively.

GP attendances for cervical screening tests by women who were not eligible

During the analysis period there was a significant 25.0% increase in the number of GP attendances for cervical screening tests by women who were not eligible (0.35 visits per practice per week to 0.44 visits, p<0.001) compared to the same period 1 year earlier. There was significant increases in the number of GP attendances for cervical screening tests by women who were not eligible in the pre-and post-campaign periods increasing by 43.2% and 77.8% respectively (both p<0.001) compared to the previous year.

Conclusions

There was a statistically significant increase in the average number of GP attendances for cervical screening tests, both overall and across individual age groups, which appears to be above the long-term trend. There was a statistically significant decrease in the number of cervical screening non-attenders during the analysis period though a similar decrease was also observed in the pre-campaign period. A statistically significant increase in the number of GP attendances for cervical screening tests by women who were not eligible were observed over the 3 periods.

Get advice on the signs and symptoms of cancer from the NHS website. You can also find out more about the evaluation of Be Clear on Cancer campaigns.

1. Women who do not attend their cervical screening appointment or women who have opted out of cervical screening ↩ ↩²

2. Including women who were not of screening age, whose tests were up to date or cervical screening test not offered. ↩ ↩²

3. The THIN database comprises of anonymised longitudinal patient records for approximately 6% of the UK Population. ↩

4. Compared to all practices nationally, these practices had a similar age-sex population structure, but a less deprived population on average. A less deprived population tends to have higher coverage which may affect the results. ↩