Cervical screening: programme overview

Information for the public about cervical screening is available on the NHS website and in the video below.

Female lifetime screening pathway

The video is also available with subtitles translated into the 10 most requested languages.

The NHS is committed to reducing inequalities and variation in screening participation to help make sure everyone has fair and equal access to screening services.

NHS England has also published information about patient confidentiality in population screening programmes.

Target population

Cervical screening is available to women and people with a cervix aged 25 to 64 in England.

All eligible people who are registered with a GP (as female) automatically receive an invitation by mail. Trans men (assigned female at birth) do not receive invitations if registered as male with their GP, but are still entitled to screening if they have a cervix.

The first invitation is sent to eligible people at the age of 24.5 years. People aged 25 to 64 receive invitations every 5 years.

Cervical screening is not recommended for anyone under 25 years old who has not been invited.

Current cervical screening IT systems are not able to include individuals registered with the NHS as ‘male’. Also, current registration systems are unable to record the gender category of ‘non-binary’. In these circumstances, the GP practice or a healthcare team managing gender reassignment should send screening invitations. You can read information on reducing cervical screening inequalities for trans people.

If you are visiting from overseas and are registered with a GP practice, you may be invited for NHS screening services. Screening is normally free, but if it leads to further tests or treatments not provided by the GP practice, you may be charged for that additional care.

Condition screened for

Cervical screening looks for the human papillomavirus (HPV) which can cause abnormal cells on the cervix. If HPV is found a cytology test is used as a triage, to check for any abnormal cells.

If no abnormal cells are found, a follow up screen is arranged for 12 months’ time. This will check to see if the immune system has cleared the virus.

Most HPV infections are transient, and slightly abnormal cells often go away on their own when the virus clears. If HPV persists, abnormal cells can, if left untreated, turn into cancer over time.

If abnormal cells are found, the individual will be referred to colposcopy.

The NHS website has more information, including:

• how cervical screening helps to prevent cancer
• what HPV is
• how HPV is spread

Screening tests

HPV test

Cervical screening samples are tested for types of HPV that can cause cervical cancer.

Testing for HPV first, rather than looking at the cells down a microscope (cytology), is proven to be a more sensitive test. It will help to find more individuals with cervical cell abnormalities that may need treatment.

HPV testing will help to prevent more cases of cervical cancer.

Results

If HPV is not found, the individual will be offered a screening test again in 5 years.

Individuals who do have HPV will have cytology triage carried out on the same sample. This is to see if HPV has caused abnormal cell changes.

For more information about possible results for cervical screening, read our cervical screening invitation leaflet.

Vaccinated women or people with a cervix

The HPV vaccination programme started in 2008. Vaccinated individuals should still consider offers of cervical screening, as the vaccine does not protect against all subtypes of HPV.

Information for immunisation practitioners and other health professionals is available to ensure they follow the correct protocols and processes.

Evidence base

Cervical screening is one of 11 NHS population screening programmes available in England.

The UK National Screening Committee (UK NSC) makes recommendations to ministers in the 4 UK countries on all aspects of population screening. It ensures that screening provides more benefit than harm, at a reasonable cost to the NHS.

Recommendations are based on internationally recognised criteria and a rigorous evidence review process.

Read the UK NSC recommendation on cervical screening.

Data and intelligence

Key performance indicator (KPI) data reports are available for all 11 national screening programmes. NHS England collects routine data to monitor the coverage of cervical screening.

Requests for screening data and research

All requests for screening data need to be approved by the NHS Cervical Screening Programme Research, Innovation and Data Advisory Committee.

There is a terms of reference for NHS population screening programme research advisory committees.

All routine data requests (not research) should go via the NHS England Contact Centre.

Commissioning

All cervical screening commissioners must follow the relevant service specification (specification number 25).

Quality assurance

Guidance is available on the programme’s processes for ensuring a safe screening pathway.

The programme specific operating model for quality assurance of the cervical screening programme should be read in conjunction with the population screening quality assurance documents and the relevant programme standards.

Workforce: education and training

Education and training resources are available for healthcare professionals working in cervical screening.

Healthcare professionals must use national guidance for cervical screening professionals.

There are also more general screening resources to support screening professionals in their initial training and continuing professional development (CPD).

It is an individual’s choice whether to have cervical screening. People can opt out if they do not want to receive screening invitations.

Keep up to date

Keep up to date with what is new in the programme, including the latest guidance and good practice.

You can register to get updates on the NHS cervical screening programme direct to your inbox. Follow the instructions to get emails about the pages you are interested in.

Contact the screening team

NHS England screening
Wellington House
133-155 Waterloo Road
London
SE1 8UG