Research and analysis

NHS Cervical Screening Programme Audit of invasive cervical cancer: Appendix B: Data Tables

Published 30 November 2023

Applies to England

1. NHS Cervical Screening Programme Audit of invasive cervical cancer: Appendix B: Data Tables

August 2023

1.1 Appendix B: Data tables

Table 1. Number and proportion of cases of invasive cervical cancer by audit year and age at diagnosis

	Audit year*
Age Group	2007 to 2008	2008 to 2009	2009 to 2010	2010 to 2011	2011 to 2012	2012 to 2013	2013 to 2014	2014 to 2015	2015 to 2016	2016 to 2017	2017 to 2018	2018 to 2019	Total
<25£	44	29	33	29	23	35	27	21	19	8	10	7	285
25-29	249	329	408	343	387	400	424	422	454	351	323	287	4377
30-39	629	664	747	564	609	593	582	586	597	592	600	599	7362
40-49	437	471	529	459	552	455	449	463	469	469	474	439	5666
50-64	370	383	401	415	412	427	366	406	403	450	435	408	4876
65+	404	414	402	365	377	392	362	343	325	312	290	315	4301
Total	2,133	2,290	2,520	2,175	2,360	2,302	2,210	2,241	2,267	2,182	2,132	2,055	26,867

^*Audit year between 1 April and 31 March

^£Note that women diagnosed aged 24.5 to 25 are included in the age group 25 to 29.

Table 2. Number and proportion of invasive cervical cancer cases by audit year and 5 year age group

Audit Year1	<20*	20 to 24£	25 to 29	30 to 34	35 to 39	40 to 44	45 to 49	50 to 55	55 to 59	60 to 64	65 to 69	70 to 74	75 to 79	80+	Total
2007 to 2008	0	44	249	308	321	251	186	132	122	116	91	87	83	143	2133
2008 to 2009	1	28	329	311	353	290	181	133	136	114	94	82	86	152	2290
2009 to 2010	0	33	408	379	368	310	219	141	134	126	94	90	76	142	2,520
2010 to 2011	0	29	343	274	290	259	200	155	128	132	93	71	72	129	2,175
2011 to 2012	1	22	387	302	307	322	230	156	134	122	88	73	88	128	2,360
2012 to 2013	1	34	400	329	264	259	196	158	157	112	112	83	85	112	2,302
2013 to 2014	1	26	424	307	275	243	206	151	122	93	107	66	78	111	2,210
2014 to 2015	1	20	422	304	282	258	205	165	132	109	91	62	84	106	2,241
2015 to 2016	0	19	454	309	288	238	231	155	128	120	86	67	73	99	2,267
2016 to 2017	0	8	351	328	264	247	222	170	150	130	90	67	64	91	2,182
2017 to 2018	0	10	323	329	271	242	232	147	160	128	83	76	60	71	2,132
2018 to 2019	1	6	287	310	289	238	201	166	148	94	75	87	52	101	2,055
Total	6	279	4,377	3,790	3,572	3,157	2,509	1,829	1,651	1,396	1,104	911	901	1,385	26,867
^Percent
2007 to 2008	0.0	2.1	11.7	14.4	15.0	11.8	8.7	6.2	5.7	5.4	4.3	4.1	3.9	6.7	100
2008 to 2009	0.0	1.2	14.4	13.6	15.4	12.7	7.9	5.8	5.9	5.0	4.1	3.6	3.8	6.6	100
2009 to 2010	0.0	1.3	16.2	15.0	14.6	12.3	8.7	5.6	5.3	5.0	3.7	3.6	3.0	5.6	100
2010 to 2011	0.0	1.3	15.8	12.6	13.3	11.9	9.2	7.1	5.9	6.1	4.3	3.3	3.3	5.9	100
2011 to 2012	0.0	0.9	16.4	12.8	13.0	13.6	9.7	6.6	5.7	5.2	3.7	3.1	3.7	5.4	100
2012 to 2013	0.0	1.5	17.4	14.3	11.5	11.3	8.5	6.9	6.8	4.9	4.9	3.6	3.7	4.9	100
2013 to 2014	0.0	1.2	19.2	13.9	12.4	11.0	9.3	6.8	5.5	4.2	4.8	3.0	3.5	5.0	101
2014 to 2015	0.0	0.9	18.8	13.6	12.6	11.5	9.1	7.4	5.9	4.9	4.1	2.8	3.7	4.7	102
2015 to 2016	0.0	0.8	20.0	13.6	12.7	10.5	10.2	6.8	5.6	5.3	3.8	3.0	3.2	4.4	103
2016 to 2017	0.0	0.4	16.1	15.0	12.1	11.3	10.2	7.8	6.9	6.0	4.1	3.1	2.9	4.2	104
2017 to 2018	0.0	0.5	15.2	15.4	12.7	11.4	10.9	6.9	7.5	6.0	3.9	3.6	2.8	3.3	105
2018 to 2019	0.0	0.3	14.0	15.1	14.1	11.6	9.8	8.1	7.2	4.6	3.6	4.2	2.5	4.9	106
Total	0.0	1.0	16.3	14.1	13.3	11.8	9.3	6.8	6.1	5.2	4.1	3.4	3.4	5.2	100

¹Audit year between 1 April and 31 March

^£ Note that women diagnosed aged 24.5 to 25 are included in the age group 25 to 29.

Table 3. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019 by audit year and age group

Audit Year	<25£	25 to 49	50 to 64	65+	Total
2016 to 2017	8	1,412	450	312	2,182
2017 to 2018	10	1,397	435	290	2,132
2018 to 2019	7	1,325	408	315	2,055
Total	25	4,134	1,293	917	6,369
Percent
2016 to 2017	0.4	64.7	20.6	14.3	100
2017 to 2018	0.5	65.5	20.4	13.6	100
2018 to 2019	0.3	64.5	19.9	15.3	100
Total	0.4	64.9	20.3	14.4	100
£Note that women diagnosed aged 24.5 to 25 are included in the age group 25 to 29.

Table 4. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by FIGO Stage

	Cases
FIGO Stage	n	%
IA NOS	411	6.5
IA1	1,476	23.2
IA2	106	1.7
IB+ NOS*	584	9.2
IB NOS*	1,141	17.9
IB1	148	2.3
IB2	66	1.0
II NOS*	142	2.2
IIA	1,022	16.0
IIB	55	0.9
III NOS*	44	0.7
IIIA	301	4.7
IIIB	156	2.4
IV NOS*	181	2.8
IVA	189	3.0
IVB	74	1.2
None available	104	1.6
None recorded	169	2.7
Total	6,369	100
*NOS= not otherwise specified (or not further specified)

Table 5. Number of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019 by age group and FIGO stage

Age	IA	IB	II	III	IV	IB+(NOS)	None Recorded	Total
<25£	5	8	8	1	2	1	0	25
25 to 49	1,775	1,339	551	144	173	33	119	4,134
50 to 64	184	369	362	107	163	24	84	1,293
65+	29	157	309	148	188	16	70	917
Total	1,993	1,873	1,230	400	526	74	273	6,369

^£Note that women diagnosed aged 24.5 to 25 are included in the age group 25 to 29.

Table 5a. FIGO stage of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019: estimated percentage distribution, by age 

Age	IA	IB	II+III	IV	Total
<25£	21.3	33.9	36.7	8.1	100
25 to 49	44.6	33.6	17.4	4.4	100
50 to 64	16.4	31.0	38.9	13.8	100
65+	4.0	19.6	53.9	22.6	100
All ages	32.9	31.0	27.1	8.9	100

^£Note that women diagnosed aged 24.5 to 25 are included in the age group 25 to 29.

Table 6. Number of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by FIGO stage and year of diagnosis

Audit year*	IA	IB	II	III	IV	IB+(NOS)	None Recorded	Total
2007 to 2008	655	630	264	144	89	120	231	2,133
2008 to 2009	692	689	300	148	121	92	248	2,290
2009 to 2010	835	772	301	171	129	104	208	2,520
2010 to 2011	692	628	324	139	122	87	183	2,175
2011 to 2012	795	690	302	143	157	97	176	2,360
2012 to 2013	712	679	393	144	149	60	165	2,302
2013 to 2014	697	685	353	145	165	50	115	2,210
2014 to 2015	756	640	406	132	132	54	121	2,241
2015 to 2016	737	690	386	149	169	28	108	2,267
2016 to 2017	704	638	423	140	168	29	80	2,182
2017 to 2018	657	630	416	139	191	17	82	2,132
2018 to 2019	632	605	391	121	167	28	111	2,055
Total	8,564	7,976	4,259	1,715	1,759	766	1,828	26,867

^*Audit year between 1 April and 31 March

Table 6a. FIGO stage of invasive cervical cancer cases: estimated percentage distribution, by year of diagnosis

Audit year	IA	IB	II+III	IV	Total
2007 to 2008	35.7	35.4	23.2	5.6	100
2008 to 2009	34.7	35.2	23.5	6.7	100
2009 to 2010	36.5	35.1	22.2	6.3	100
2010 to 2011	35.6	33.1	24.6	6.8	100
2011 to 2012	37.1	33.1	22.1	7.8	100
2012 to 2013	34.4	31.9	26.1	7.6	100
2013 to 2014	34.2	33.1	24.5	8.2	100
2014 to 2015	34.1	32.0	26.9	7.0	100
2015 to 2016	34.4	32.3	25.2	8.0	100
2016 to 2017	33.8	30.9	27.1	8.2	100
2017 to 2018	32.1	30.8	27.5	9.7	100
2018 to 2019	32.9	31.5	26.7	8.9	100
Total	34.7	32.9	24.9	7.5	100

^*Audit year between 1 April and 31 March

Table 7. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by histology

Audit year	Squamous	Adenocarcinoma	Adeno-Squamous	Undifferentiated	Other	None recorded	Total
2007 to 2008	1,496	406	59	12	30	130	2,133
2008 to 2009	1,615	459	67	14	30	105	2,290
2009 to 2010	1,795	504	75	11	33	102	2,520
2010 to 2011	1,597	399	55	4	41	79	2,175
2011 to 2012	1,692	459	67	14	37	91	2,360
2012 to 2013	1,619	479	68	6	31	99	2,302
2013 to 2014	1,564	446	66	6	44	84	2,210
2014 to 2015	1,508	448	63	4	37	181	2,241
2015 to 2016	1,331	404	34	8	41	449	2,267
2016 to 2017	1,302	357	47	6	42	428	2,182
2017 to 2018	1,457	438	41	4	32	160	2,132
2018 to 2019	1,408	375	38	8	31	195	2,055
Total	18,384	5,174	680	97	429	2,103	26,867
Percent
2007 to 2008	70.1	19.0	2.8	0.6	1.4	6.1	100
2008 to 2009	70.5	20.0	2.9	0.6	1.3	4.6	100
2009 to 2010	71.2	20.0	3.0	0.4	1.3	4.0	100
2010 to 2011	73.4	18.3	2.5	0.2	1.9	3.6	100
2011 to 2012	71.7	19.4	2.8	0.6	1.6	3.9	100
2012 to 2013	70.3	20.8	3.0	0.3	1.3	4.3	100
2013 to 2014	70.8	20.2	3.0	0.3	2.0	3.8	100
2014 to 2015	67.3	20.0	2.8	0.2	1.7	8.1	100
2015 to 2016	58.7	17.8	1.5	0.4	1.8	19.8	100
2016 to 2017	59.7	16.4	2.2	0.3	1.9	19.6	100
2017 to 2018	68.3	20.5	1.9	0.2	1.5	7.5	100
2018 to 2019	68.5	18.2	1.8	0.4	1.5	9.5	100
Total	68.4	19.3	2.5	0.4	1.6	7.8	100

^*Audit year between 1 April and 31 March

Table 8. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by age at diagnosis and histology

Age	Squamous	Adenocarcinoma	Adeno-Squamous	Other (incl undiff)	None recorded	Total
<25	13	3	1	3	5	25
25 to 49	2,740	739	77	56	522	4,134
50 to 64	820	272	28	34	139	1,293
65+	594	156	20	30	117	917
Total	4,167	1,170	126	123	783	6,369
Percent
<25	52.0	12.0	4.0	12.0	20.0	100
25 to 49	66.3	17.9	1.9	1.4	12.6	100
50 to 64	63.4	21.0	2.2	2.6	10.8	100
65+	64.8	17.0	2.2	3.3	12.8	100
Total	65.4	18.4	2.0	1.9	12.3	100

Table 9. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by FIGO Stage and histology

Stage	Squamous	Adenocarcinoma	Adeno-Squamous	Other (incl undiff)	None recorded	Total
IA	1,472	240	7	18	256	1,993
IB	1,012	547	59	27	228	1,873
II&III	1,124	230	40	32	204	1,630
IV	330	78	16	26	76	526
IB+(NOS)	45	22	1	4	2	74
None recorded	184	53	3	16	17	273
Total	4,167	1,170	126	123	783	6,369
Percent
IA	35.3	20.5	5.6	14.6	32.7	31.3
IB	24.3	46.8	46.8	22.0	29.1	29.4
II&III	27.0	19.7	31.7	26.0	26.1	25.6
IV	7.9	6.7	12.7	21.1	9.7	8.3
IB+(NOS)	1.1	1.9	0.8	3.3	0.3	1.2
None recorded	4.4	4.5	2.4	13.0	2.2	4.3
Total	100	100	100	100	100	100

Treatment	<25	25 to 49	50 to 64	65+	Total
None	1	72	25	62	160
Cone biopsy/ Loop excision	6	1,288	98	15	1,407
Trachalectomy	1	112	2	1	116
Simple hysterectomy	0	274	72	15	361
Radical hysterectomy	3	566	173	47	789
Radiotherapy ± hysterectomy	0	23	10	11	44
Chemotherapy ± hysterectomy	0	8	4	3	15
Chemotherapy + radiotherapy ± hysterectomy	0	66	25	12	103
Radiotherapy	0	46	56	159	261
Chemotherapy	0	101	58	40	199
Radiothearpy + Chemotherapy	8	642	424	284	1,358
Palliative care	0	19	30	62	111
Other	0	2	0	0	2
None recorded	6	915	316	206	1,443
Total	25	4,134	1,293	917	6,369

Table 10. Number of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by treatment and age group

Table 10a. Proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by treatment and age group

Treatment	<25	25 to 49	50 to 64	65+	Total
None	4.0	1.7	1.9	6.8	2.5
Cone biopsy/ Loop excision	24.0	31.2	7.6	1.6	22.1
Trachalectomy	4.0	2.7	0.2	0.1	1.8
Simple hysterectomy	0.0	6.6	5.6	1.6	5.7
Radical hysterectomy	12.0	13.7	13.4	5.1	12.4
Radiotherapy ± hysterectomy	0.0	0.6	0.8	1.2	0.7
Chemotherapy ± hysterectomy	0.0	0.2	0.3	0.3	0.2
Chemotherapy + radiotherapy ± hysterectomy	0.0	1.6	1.9	1.3	1.6
Radiotherapy	0.0	1.1	4.3	17.3	4.1
Chemotherapy	0.0	2.4	4.5	4.4	3.1
Radiothearpy + Chemotherapy	32.0	15.5	32.8	31.0	21.3
Palliative care	0.0	0.5	2.3	6.8	1.7
Other	0.0	0.0	0.0	0.0	0.0
None recorded	24.0	22.1	24.4	22.5	22.7
Total	100	100	100	100	100

Table 11. Number and proportion of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by age at diagnosis and treatment

Treatment	<50	50 to 64	65 to 79	80+	Total
None(palliative)	92	55	58	66	271
Cone biopsy/ Loop excision	1,294	98	8	7	1,407
Trachalectomy	113	2	1	0	116
Hysterectomy only (simple or radical)	843	245	51	11	1,150
Radiotherapy ± hysterectomy	69	66	93	77	305
Chemotherapy ± hysterectomy	109	62	36	7	214
Chemo + radiotherapy ± hysterectomy	716	449	264	32	1,461
Not recorded (Other)	923	316	143	63	1,445
Total	4,159	1,293	654	263	6,369
Percent
None(palliative)	2.2	4.3	8.9	25.1	4.3
Cone biopsy/ Loop excision	31.1	7.6	1.2	2.7	22.1
Trachalectomy	2.7	0.2	0.2	0.0	1.8
Hysterectomy only (simple or radical)	20.3	18.9	7.8	4.2	18.1
Radiotherapy ± hysterectomy	1.7	5.1	14.2	29.3	4.8
Chemotherapy ± hysterectomy	2.6	4.8	5.5	2.7	3.4
Chemo + radiotherapy ± hysterectomy	17.2	34.7	40.4	12.2	22.9
Not recorded (Other)	22.2	24.4	21.9	24.0	22.7
Total	100	100	100	100	100

Table 12. Number of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019, by FIGO Stage and treatment

Treatment	IA	IB	II	III	IV	IB+(NOS)	None recorded	Total
None(palliative)	38	39	30	34	106	0	24	271
Cone biopsy/ Loop excision	1,179	182	15	5	3	2	21	1,407
Trachalectomy	11	101	2	0	0	0	2	116
Hysterectomy only (simple or radical)	300	791	33	6	4	2	14	1,150
Radiotherapy ± hysterectomy	4	64	117	41	62	2	15	305
Chemotherapy ± hysterectomy	1	25	58	28	93	1	8	214
Chemo + radiotherapy ± hysterectomy	21	242	782	222	173	2	19	1,461
Not recorded (Other)	439	429	193	64	85	65	170	1,445
Total	1,993	1,873	1,230	400	526	74	273	6,369

Table 12a. FIGO stage of invasive cervical cancer cases: estimated percentage distribution in the audit between 1 April 2016 and 31 March 2019, by treatment

Treatment	IA	IB	II+III	IV	Total
None(palliative)	15.0	15.7	26.3	43.1	100
Cone biopsy/ Loop excision	85.1	13.3	1.5	0.2	100
Trachalectomy	10.7	87.6	1.8	0.0	100
Hysterectomy only (simple or radical)	26.4	69.8	3.5	0.4	100
Radiotherapy ± hysterectomy	1.4	21.7	55.1	21.8	100
Chemotherapy ± hysterectomy	0.5	12.2	41.9	45.3	100
Chemo + radiotherapy ± hysterectomy	1.5	16.8	69.7	12.0	100
Not recorded (Other)	35.8	35.0	21.9	7.3	100
Total	32.9	31.0	27.1	8.9	100

Table 13. Cervical screening status of invasive cervical cancer cases and controls aged 25 to 64 in the audit between 1 April 2016 and 31 March 2019, up to 6 months prior to diagnosis (proportions)

Cervical screening status up to six months prior to diagnosis	Population Controls		Cases Stage IA		Cases Stage IB+		Cases Stage not recorded
	n	%	n	%	n	%	n	%
No cytology test (except within 6 months of diag)	1,519	14.4	755	38.5	1,212	37.1	51	25.1
Last test routine and
Up to date	6,387	60.5	415	21.2	649	19.9	49	24.1
Lapsed	1,876	17.8	454	23.2	889	27.2	62	30.5
Last test early repeat
Up to date	109	1.0	31	1.6	23	0.7	1	0.5
Lapsed	406	3.8	90	4.6	250	7.7	20	9.9
Last test suspend
Up to date	52	0.5	15	0.8	15	0.5	3	1.5
Lapsed	203	1.9	199	10.2	227	7.0	17	8.4
Total	10,552	100	1,959	100	3,265	100	203	100

We have used the action code provided by the Exeter call  nd recall service to determine whether the last cytology test lead to a routine recall, early recall or suspend from the recall programme. After a routine recall interval, we consider the screening to be up to date when the diagnosis occurred within 3.5 years (or 5.5 years for older people) from the routine cytology test. After an action code of early repeat, we consider the screening to be up to date when the diagnosis occurred within 1.25 years (or 0.25 years if the test was inadequate) of the early repeat test. When the last test (6 months before diagnosis) resulted in a ‘suspend’ code recommending referral to colposcopy and was followed by at least one negative test, people were up to date if the diagnosis was made within 1.5 years of the test leading to the suspend code. Those that were suspended more than 6 months before diagnosis and are not followed by any negative tests are lapsed.

Table 14 Cervical screening status of invasive cervical cancer cases and controls up to 6 months prior to diagnosis (numbers and proportions) in the audit between 1 April 2016 and 31 March 2019, by age

Cervical screening status up to six months prior to diagnosis		All Cases		Controls
20-24	25 to 49	50 to 64	65 to 79	80+	20 to 24	25 to 49	50 to 64	65 to 79	80+
No cytology test (except within six months of diag)	25	1,686	332	194	86	47	1,420	99	88	148
Last test routine and
Up to date	0	784	329	258	144	1	4,631	1,756	895	311
Lapsed	0	990	415	144	16	0	1,334	542	247	42
Last test early repeat and
Up to date	0	47	8	2	9	0	96	13	6	1
Lapsed	0	250	110	37	8	0	328	78	33	11
Last test suspend*	0	377	99	19	0	0	224	31	9	1
Total	25	4,134	1,293	654	263	48	8,033	2,519	1,278	514
Percent
No cytology test (except within six months of diag)	100	40.8	25.7	29.7	32.7	97.9	17.7	3.9	6.9	28.8
Last test routine and
Up to date	0.0	19.0	25.4	39.4	54.8	2.1	57.6	69.7	70.0	60.5
Lapsed	0.0	23.9	32.1	22.0	6.1	0.0	16.6	21.5	19.3	8.2
Last test early repeat and
Up to date	0.0	1.1	0.6	0.3	3.4	0.0	1.2	0.5	0.5	0.2
Lapsed	0.0	6.0	8.5	5.7	3.0	0.0	4.1	3.1	2.6	2.1
Last test suspend*	0.0	9.1	7.7	2.9	0.0	0.0	2.8	1.2	0.7	0.2
Total	100	100	100	100	100	100	100	100	100	100

• The categories “last test suspend (not followed by any negative)” and “last test suspend (followed by at least one negative)” found in table 14 are combined due to small numbers. Note that screening histories for women over age 65 are based on tests at ages 50-64.

Table 15. Number and percentage of population controls (GP plus district controls) screened in the 3 to 5-year interval preceding the date of diagnosis of their matched case, by age

Age		Total	Not screened in previous interval	Screened once in previous interval	Screened twice in previous interval	Screened ≥3 times in previous interval
20 to 24		255	202	53	0	0
25 to 29		1,666	682	916	55	13
30 to 34		1,875	654	1,152	58	11
35 to 39		1,595	550	991	44	10
40 to 44		1,425	501	893	26	5
45 to 49		1,265	414	824	25	2
50 to 54		940	223	455	248	14
55 to 59		894	275	588	21	10
60 to 64		685	216	451	12	6
65 to 69		482	155	318	6	3
70 to 74		449	110	287	45	7
75 to 79		347	92	166	68	21
80+		514	191	220	94	9
Total		12,392	4,265	7,314	702	111
Percent	National Coverage reported in 2018*	Coverage (>=1 test in interval)	%	%	%	%
20 to 24	2.2	20.8†	79.2	20.8	0.0	0.0
25 to 29	64.2	59.1	40.9	55.0	3.3	0.8
30 to 34	75.8	65.1	34.9	61.4	3.1	0.6
35 to 39	77.9	65.5	34.5	62.1	2.8	0.6
40 to 44	79.6	64.8	35.2	62.7	1.8	0.4
45 to 49	80.1	67.3	32.7	65.1	2.0	0.2
50 to 54	78.4	76.3	23.7	48.4	26.4	1.5
55 to 59	72.6	69.2	30.8	65.8	2.3	1.1
60 to 64	68.9	68.5	31.5	65.8	1.8	0.9
65 to 69	-	67.8	32.2	66.0	1.2	0.6
70 to 74	-	75.5	24.5	63.9	10.0	1.6
75 to 79	-	73.5	26.5	47.8	19.6	6.1
80+	-	62.8	37.2	42.8	18.3	1.8
Total			34.4	59.0	5.7	0.9

*Source: NHS Cervical Screening Programme in England in 2018-19. Note: we have used the 3.5 yearly coverage for women aged 20-49 and the 5.5 yearly coverage for women aged 50-64 using table 1a (see reference 2)

† Note: 77% of controls aged 20-24 are aged 24, only 3% are aged 20 or 21. Thus this age group is a reflection of the age at which their matched cases were diagnosed and not of the distribution of women aged 20-24 nationally. This explains the difference in coverage nationally and in the audit.

Table 15a. Number and proportion of population controls (GP plus district controls) screened in the 3 to 5-year interval preceding the date of diagnosis of their matched case, by age group

Age group	Total	Not screened in previous interval	Screened once in previous interval	Screened twice in previous interval	Screened ≥3 times in previous interval
<24.5	48	46	2	0	0
25 to 34	3,748	1,492	2,119	113	24
35 to 49	4,285	1,465	2,708	95	17
50 to 64	2,519	714	1,494	281	30
65 to 74	931	265	605	51	10
75+	861	283	386	162	30
Total	12,392	4,265	7,314	702	111
Percent	Coverage (>=1 test in interval)
<24.5	4.2	95.8	4.2	0.0	0.0
25 to 34	60.2	39.8	56.5	3.0	0.6
35 to 49	65.8	34.2	63.2	2.2	0.4
50 to 64	71.7	28.3	59.3	11.2	1.2
65 to 74	71.5	28.5	65.0	5.5	1.1
75+	67.1	32.9	44.8	18.8	3.5
Total		34.4	59.0	5.7	0.9

Table 16. Time to previous cytology among screened controls 1,2

	Time to previous screen
Age	<2.75 yrs	2.75-3.5 yrs	3.5-4.75 yrs	4.75-5.5 yrs	5.5-9.5 yrs	No previous cytology within 9.5 years	Total
25 to 29	14	94	30	4	3	157	302
30 to 34	17	158	47	13	42	64	341
35 to 39	10	137	31	9	35	39	261
40 to 44	9	101	37	4	26	19	196
45 to 49	2	91	27	5	25	10	160
50 to 54	0	38	8	5	14	6	71
55 to 59	1	0	1	34	18	7	61
60 to 64	0	0	1	41	6	1	49
Total	53	619	182	115	169	303	1,441
Percent
25 to 29	4.6	31.1	9.9	1.3	1.0	52.0	100
30 to 34	5.0	46.3	13.8	3.8	12.3	18.8	100
35 to 39	3.8	52.5	11.9	3.4	13.4	14.9	100
40 to 44	4.6	51.5	18.9	2.0	13.3	9.7	100
45 to 49	1.3	56.9	16.9	3.1	15.6	6.3	100
50 to 54	0.0	53.5	11.3	7.0	19.7	8.5	100
55 to 59	1.6	0.0	1.6	55.7	29.5	11.5	100
60 to 64	0.0	0.0	2.0	83.7	12.2	2.0	100
Total	3.7	43.0	12.6	8.0	11.7	21.0	100

¹ When a case is identified as potentially screen-detected (one in which cytology results are consistent with screen detection) a screen control is then selected (one with a cytology test taken close in calendar time to the test from which the case was screen detected).

² Screened controls from cases in the audit between 1 April 2016 and 31 March 2019.

Table 16a. Time to previous cytology test among potentially screen-detected1,2 cases of cervical cancer and their screened controls

		Time to previous screen
Age	<3.5 yrs	3.5-4.75 yrs	4.75-5.5 yrs	5.5-9.5 yrs	No previous cytology within 9.5 yrs	Total	<5.5 yrs
	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls
28 to 34	222	256	84	75	22	16	51	43	138	113	517	503	328	347
35 to 49	183	350	69	95	16	18	112	86	247	68	627	617	268	463
50 to 64	20	39	5	10	53	80	36	38	68	14	182	181	78	129
Total	425	645	158	180	91	114	199	167	453	195	1,326	1,301	674	939
Percent
	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls
28 to 34	42.9	50.9	16.2	14.9	4.3	3.2	9.9	8.5	26.7	22.5	100	100	63.4	69.0
35 to 49	29.2	56.7	11.0	15.4	2.6	2.9	17.9	13.9	39.4	11.0	100	100	42.7	75.0
50 to 64	11.0	21.5	2.7	5.5	29.1	44.2	19.8	21.0	37.4	7.7	100	100	42.9	71.3
Total	32.1	49.6	11.9	13.8	6.9	8.8	15.0	12.8	34.2	15.0	100	100	50.8	72.2

¹ A potentially screen-detected case is one in which cytology results are consistent with screen detection; there is no national record of whether the cytology was in response to screening or to symptoms

² Screen-detected cases in the audit between 1 April 2016 and 31 March 2019.

Table 17. Maximum interval* between cytology tests (over the previous 8 years) among cases with FIGO stage 1B+ diagnosed in the audit between 1 April 2016 and 31 March 2019 and their population controls

Age	<3.5 yrs		3.5-4.75 yrs		4.75-5.5 yrs		5.5-7yrs		>7 yrs or no cytology		Total
	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls	Cases	Controls
28 to 34	73	304	122	369	75	184	42	151	365	306	677	1,314
35 to 49	167	1,101	160	580	68	218	103	266	907	563	1,405	2,728
50 to 64	61	344	84	458	141	523	65	218	674	449	1,025	1,992
Total	301	1,749	366	1,407	284	925	210	635	1,946	1,318	3,107	6,034
Percent
28 to 34	10.8	23.1	18.0	28.1	11.1	14.0	6.2	11.5	53.9	23.3	100	100
35 to 49	11.9	40.4	11.4	21.3	4.8	8.0	7.3	9.8	64.6	20.6	100	100
50 to 64	6.0	17.3	8.2	23.0	13.8	26.3	6.3	10.9	65.8	22.5	100	100
Total	9.7	29.0	11.8	23.3	9.1	15.3	6.8	10.5	62.6	21.8	100	100

 * This analysis shows the longest period between tests in the 8 years preceding the date of diagnosis of the case. People under age 28 are not included in this analysis because (even allowing for screening from age 20) they would not have been eligible for screening for the whole of the previous 8 years.

Table 18. Number and percentage of invasive cervical cancer cases in the audit between 1 April 2016 and 31 March 2019 with colposcopic appointment recorded, by age group

Age group	Number of cases	Cases with a recorded colposcopy		Cases with a colposcopy review record*		Cases with an action code “suspend”		Cases with a “suspend” code >4 months before diagnosis		Cases with “Suspend” >4 months before diagnosis + colposcopy		Cases with “Suspend” >4 months before diagnosis + colposcopy (excluding colposcopy  within 2 months of diagnosis)
		n	%	n	%	n	%	n	%	n	%	n	%
<25	25	11	44.0	0	-	4	16.0	0	0.0	0	-	0	-
25-34	1,928	1,412	73.2	125	79.6	1,544	80.1	208	10.8	157	75.5	115	55.3
35-49	2,206	1,421	64.4	131	43.4	1,536	69.6	432	19.6	302	69.9	156	36.1
50-64	1,293	556	43.0	50	33.6	661	51.1	280	21.7	149	53.2	76	27.1
65-74	478	97	20.3	9	42.9	103	21.5	78	16.3	21	26.9	9	11.5
75+	439	82	18.7	8	88.9	45	10.3	40	9.1	9	22.5	4	10.0
Total	6,369	3,579	56.2	323	50.6	3,893	61.1	1038	16.3	638	61.5	360	34.7

*Percent with a colposcopy review is out of those with a suspend code >4 months before diagnosis + colposcopy.

Table 19. Original cytology result by review result from cases diagnosed in the audit between 1 April 2006 and 31 March 2019 *

Review Result

Original result	Negative		Inadequate		Borderline		Low-grade (mild)		?Glandular (non-cervical)		High-grade (Moderate)		High-grade (severe)		?Invasive		?Glandular		Total
	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
Negative	10015	52.3	863	4.5	3276	17.1	371	1.9	13	0.1	595	3.1	2558	13.4	133	0.7	1316	6.9	19140	100
Inadequate	150	9.3	881	54.4	237	14.6	23	1.4	1	0.1	35	2.2	184	11.4	34	2.1	75	4.6	1620	100
Borderline	86	2.7	31	1.0	1288	40.5	239	7.5	5	0.2	210	6.6	853	26.8	64	2.0	408	12.8	3184	100
Low-grade (mild)	16	1.6	2	0.2	88	8.8	451	44.9	0	0.0	181	18.0	211	21.0	31	3.1	25	2.5	1005	100
?Glandular (non-cervical)	0	0.0	0	0.0	0	0.0	0	0.0	7	50.0	0	0.0	0	0.0	5	35.7	2	14.3	14	100
High-grade (moderate)	5	0.6	0	0.0	8	1.0	22	2.7	1	0.1	293	36.3	417	51.7	38	4.7	23	2.9	807	100
High-grade (severe)	13	0.3	2	0.0	12	0.3	5	0.1	0	0.0	31	0.7	3444	82.1	458	10.9	229	5.5	4194	100
?Invasive	4	0.3	0	0.0	2	0.1	0	0.0	0	0.0	0	0.0	120	8.1	1338	90.2	20	1.3	1484	100
?Glandular	4	0.3	2	0.2	5	0.4	0	0.0	0	0.0	1	0.1	63	5.1	27	2.2	1130	91.7	1232	100
Total	10293	31.5	1781	5.4	4916	15.0	1111	3.4	27	0.1	1346	4.1	7850	24.0	2128	6.5	3228	9.9	32680	100

• This is an updated version of Table 1 in Castanon et al , Cytopathology, 2012.

Table 20. Review result from cases diagnosed in the audit between 1 April 2007 and 31 March 2019 with a negative cytology result within 2 years of diagnosis by audit year of diagnosis

Review Result

Audit report period	Negative		Inadequate		Borderline		Low-grade (mild)		?Glandular (non-cervical)		High-grade (Moderate)		High-grade (severe)		?Invasive		?Glandular		Total
	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
	April 2007 to March 2013*	464	41.4	25	2.2	217	19.3	25	2.2	2	0.2	35	3.1	188	16.8	31	2.8	135	12.0	1,122	100
	April 2013 to March 2016	185	38.1	6	1.2	126	25.9	5	1.0	6	1.2	12	2.5	88	18.1	10	2.1	48	9.9	486	100
	April 2016 to March 2019	141	34.1	6	1.4	73	17.6	8	1.9	2	0.5	12	2.9	89	21.5	21	5.1	62	15.0	414	100
	Total	790	39.1	37	1.8	416	20.6	38	1.9	10	0.5	59	2.9	365	18.1	62	3.1	245	12.1	2,022	100

*To note that the criteria for determining cases requiring review changed after March 2013

Table 21. Review result from cases diagnosed in the audit between 1 April 2007 and 31 March 2019 with a negative cytology result taken between 2 and 4 years prior to diagnosis by audit year of diagnosis

Review Result

Audit report period	Negative		Inadequate		Borderline		Low-grade (mild)		?Glandular (non-cervical)		High-grade (Moderate)		High-grade (severe)		?Invasive		?Glandular		Total
N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
April 2007 to March 2013	1285	45.5	90	3.2	597	21.1	64	2.3	0	0.0	94	3.3	464	16.4	29	1.0	200	7.1	2,823	100
April 2013 to March 2016	551	43.1	11	0.9	230	18.0	15	1.2	0	0.0	44	3.4	267	20.9	12	0.9	148	11.6	1,278	100
April 2016 to March 2019	589	42.3	6	0.4	206	14.8	20	1.4	3	0.2	75	5.4	311	22.3	6	0.4	176	12.6	1,392	100
Total	2425	44.1	107	1.9	1033	18.8	99	1.8	3	0.1	213	3.9	1042	19.0	47	0.9	524	9.5	5,493	100

Table 22. Audit of Invasive Cervial Cancer: number and percentage of deprivation quintiles of cases of invasive cervical cancer by age group at diagnosis

Deprivation quintiles	<25	25 to 49	50 to 64	65+	Total
0 to 1	9	1,017	311	176	1,513
2 to 3	7	788	229	171	1,195
4 to 5	1	687	215	159	1,062
6 to 7	4	594	198	148	944
8 to 10	2	563	204	184	953
Total	23	3,649	1,157	838	5,667
Percent
0 to 1	39%	28%	27%	21%	27%
2 to 3	30%	22%	20%	20%	21%
4 to 5	4%	19%	19%	19%	19%
6 to 7	17%	16%	17%	18%	17%
8 to 10	9%	15%	18%	22%	17%
Total	100%	100%	100%	100%	100%

Table 23. Audit of Invasive Cervial Cancer: number and percentage of deprivation quintiles of cases of invasive cervical cancer by FIGO stage at diagnosis

Deprivation quintiles	1A	1B	2	Total
0 to 1	499	451	563	1513
2 to 3	374	372	449	1195
4 to 5	339	343	380	1062
6 to 7	321	305	318	944
8 to 10	315	287	352	953
Total	1,847	1,758	2,063	5,667
0 to 1	27%	26%	27%	27%
2 to 3	20%	21%	22%	21%
4 to 5	18%	20%	18%	19%
6 to 7	17%	17%	15%	17%
8 to 10	17%	16%	17%	17%
Total	100%	100%	100%	100%