Guidance

Patient leaflet: reviewing your cervical screening history

Updated 26 September 2024

Applies to England

We know that this is a difficult time for you. Naturally you will be concerned about your treatment and future health. You may also be wondering why you have developed cervical cancer, especially if you have had cervical screening tests (often known as smear tests) in the past.

We review the cervical screening history of everyone diagnosed with cervical cancer to see that any cervical screening tests and investigations have been carried out in line with NHS Cervical Screening Programme standards. Reviews are an essential part of every high-quality screening programme and are a routine part of the cervical screening process. Information we gather from individual cases helps to improve the programme and learn more about how cancers develop and how they are diagnosed.

Whilst regular cervical screening is the best way to reduce the risk of developing cervical cancer by detecting abnormal cells on the cervix early on, like all screening tests it is not perfect. Abnormal cells can be missed, even in the best performing screening programmes which meet all the quality standards.

If you would like to know the results of your cervical screening history review, please fill in your response form and return it to us. The review is likely to take at least 6 months to complete. We will contact you when your results are available, and arrange a convenient time for you to come and discuss them with your hospital doctor.

The cervical screening history review

We review all records connected to your cervical screening history from the past 10 years. This includes your invitation letters, cervical screening tests, result letters and any medical investigations related to cervical screening. A group of professionals will look again at your previous tests and your medical notes related to cervical screening.

Cervical screening has recently changed to human papillomavirus (HPV) primary screening. All screening samples that are HPV positive (contain HPV) are put onto a slide to be checked under a microscope for abnormal cells (cytology). These cytology slides will be reviewed. We are not able to review samples that are only HPV tested (not put onto a slide), as they are not kept.

In most cases, a review will show that the correct procedures have been followed, and appropriate care was received. Occasionally, a review may find that one or more steps in the process have not worked as well as they should. This can highlight where we could make improvements to the screening programme.

Cancer detection

Screening history reviews usually find that a cervical cancer has been found at the earliest possible stage. Although cervical screening prevents most cervical cancers (about 7 out of 10), it cannot prevent all of them. The review process aims to highlight any areas which could be improved in the future. Some examples of issues that can be found are described below.

Identifying abnormal cells

Screening cannot always identify abnormal cells on a cytology slide because:

• sometimes abnormal cells do not look much different from normal cells
• there may be very few abnormal cells on the slide
• the person ‘reading’ the slide may not identify the abnormal cells (this happens occasionally, no matter how experienced the reader is)

Colposcopy

Colposcopy (a visual examination of the cervix) cannot always identify abnormal areas of the cervix because:

• the abnormal area might not be visible during the examination
• the abnormal area might not be sampled in a biopsy (a small tissue sample)
• the abnormal cells might be hidden higher up inside the cervix
• some types of abnormality are very difficult to identify at a colposcopy

How we use your information

We routinely collect and review screening information as part of an ongoing audit process. This is carried out confidentially. Your information (without your name) helps us make improvements and discover more about how cancers develop and how to better diagnose and treat them. The audit is done whether or not you want to know the results of the review.

Why we offer cervical screening

Cervical screening reduces the risk of developing cervical cancer by treating abnormal cells before they can develop into cancer. The cervical screening programme saves thousands of lives a year in England.

Next steps in your cervical screening history review

Please fill in the review results response form and return it to us. When the review is complete, we will contact you to let you know. If you wish to know the results, we will arrange for your hospital doctor to meet with you to discuss them in detail.

We understand this is a difficult time and it is completely up to you to decide whether you want to know the results of your review.

If you decide you do not want to know your results now, you can change your mind at any time and contact your hospital doctor or GP. They will make arrangements for you to receive your results.

Please note that unless you give us permission, we cannot give your review results to your relatives.