Modernising the NHS cervical screening programme

Cancer Research UK

Today, at the Britain Against Cancer conference, the NHS Cervical Screening Programme announces the introduction of liquid based cytology (LBC) and a change in national policy.

Following a recommendation by the National Institute for Clinical Excellence (NICE), LBC will be introduced across the cervical screening programme in England.

LBC will:

  • Reduce the number of "inadequate" tests and hence the number of women who have to be recalled for repeat testing
  • Reduce pressure on a skilled workforce. They will have fewer inadequate smears to look at and clearer samples to report
  • Reduce levels of anxiety in women who accept their invitation for cervical screening due to the quicker reporting time and a reduction in the number of women whose tests have to be taken again

The roll-out of LBC will take place over the next five years as laboratory staff and sample takers are retrained.

Also, the Advisory Committee on Cervical Screening has accepted recommendations made by Cancer Research UK scientists on the optimal frequency of cervical screening. Current policy is to screen women aged 20-64 at least every five years. National recommendations will be changed as follows:

Age...........Frequency

25..............First invitation 25-49..........3 yearly 50-64..........5 yearly

These changes represent a great investment for the NHS Cancer Screening Programmes. Three yearly screening will cost more than five yearly screening and the introduction of LBC will cost £10 million. However, the introduction of LBC will be cost effective in the long term.

Julietta Patnick, Director of the NHS Cancer Screening Programmes said:

"I am delighted that NICE has recommended the introduction of LBC. This is an example of the NHS Cervical Screening Programme taking advantage of new technology which will benefit both women and staff. I am also pleased that we are able to standardise the interval for screening based on good evidence from our own programme. These changes, in our view, mean that English women will have access to the best cervical screening programme in the world."

Public Health Minister Melanie Johnson said:

"This is good news for women. At the moment up to 300,000 women a year have to have their screening test re-done because it cannot be read properly causing real anxiety and uncertainty. LBC will make the test for cervical screening easier to read and reduce the number of times that a woman may have to go to have a test retaken. The Government will be making available £7.2 million over the next two years to help fund the national implementation. We are also using this opportunity to modernise the entire cervical screening programme and standardise the service around the country so reducing inequalities."

Professor Jack Cuzick, Director of Cancer Research UK's Department of Mathematics, Statistics and Epidemiology, said:

"This announcement will save many women from the inconvenience and anxiety of having to return for a repeat smear following an unsatisfactory result.

"It is heartening to see that the NHS is acting upon research recommendations so promptly. The evidence very strongly suggests that 5-yearly screening is sufficient in older women, but that there is a clear additional benefit of more frequent screening in younger women. The adoption of these proposals will put an end to the current post-code lottery, in which women are invited either three yearly or five yearly depending on where they live."

Britain Against Cancer is hosted by the All Party Parliamentary Group and is one of the biggest conferences of its kind. The theme of this year's conference is "Cancer Plan 2 - towards 2010: the future of cancer care in the UK." More than four hundred patients, health professionals, policymakers and charity representatives will discuss the success of the current National Cancer Plan and look at the impact of public policy on cancer services, care, prevention and research in the future, specifically looking forward to the next Cancer Plan. Speakers include Public Health Minister Melanie Johnson, Professor Mike Richards, Sir Richard Doll, Liz Kendall, Professor Alex Markham, Chief Executive of Cancer Research UK, Peter Cardy, Chief Executive of Macmillan Cancer Relief, and Joanne Rule, Chief Executive of CancerBACUP.

ENDS

Notes to Editor

  1. The NHS Cervical Screening Programme is directly responsible for a 42 per cent drop in incidence in cervical cancer between 1988 and 1997 (England and Wales). It saves around 1,300 lives per year.
  2. In England 927 deaths from cervical cancer were recorded in 2002 , down from 1,046 in 2001.
  3. Cancer Research UK has evaluated the interval for cervical screening. The findings indicate that a more effective screening programme can be provided by changing the frequency of screening according to a woman's age.
  4. Cervical cancer is very rare in women under 25. In 2002, five deaths from cervical cancer were registered for women aged between 15 and 24. Twenty six cases of cervical cancer were registered in 2000.
  5. In response to recommendations from the National Institute for Clinical Excellence (NICE), the NHS Cervical Screening Programme carried out a pilot project at three sites in England (Bristol, Newcastle and Norwich) to evaluate all the effects, costs and practical implications of introducing LBC technology into the programme.
  6. The pilot evaluation report estimated that it will cost £10 million to convert from conventional screening to LBC. The Government is providing £7.2 million over two years to kick start national rollout. Thereafter funding will be supplied from PCT baselines.
  7. LBC will be rolled out nationally across the programme. Roll-out across England is expected to take five years. All NHS Cervical Screening Programme cervical cytology training schools in England will be trained as part of the first phase of implementation. SHAs have been issued with advice on how best they can roll out LBC for their local populations, laboratories and primary care.
  8. No screening technology will be 100 per cent accurate. Cervical screening can prevent 80 to 90 per cent of cancer cases in women who attend for regular smears. Screening is one of the best defences against cervical cancer.
  9. The evaluation of LBC report is available at www.cancerscreening.nhs.uk.