Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
In the United Kingdom, the NHS cervical screening programme is available to women aged 25–64 years in England NICE CKS,NICE CKS. The primary objective of this programme is the early detection of precancerous lesions, such as high-grade cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ, to enable effective treatment and prevent invasive cancer NICE CKS,NICE CKS.
- Screening Process: All cervical samples are initially screened for high-risk human papillomavirus (hrHPV) subtypes NICE CKS. Cytology testing is only performed as a triage test if hrHPV is detected NICE CKS.
- Negative hrHPV Result: If a person tests negative for hrHPV, they are classified as 'negative' and can be safely returned to routine recall NICE CKS.
- Positive hrHPV Result:
- If a person tests positive for hrHPV, a cytology test is performed NICE CKS.
- If the cytology report is negative, the HPV test should be repeated at 12 months NICE CKS. If this repeat HPV test is negative, the person can return to routine recall NICE CKS.
- If the HPV test remains positive at 12 months, another repeat HPV test should be performed in a further 12 months (at 24 months from the initial positive test) NICE CKS. If this 24-month HPV test is negative, the person can return to routine recall NICE CKS.
- If the HPV test remains positive at 24 months, the person should be referred to colposcopy NICE CKS.
- If a person is hrHPV positive and receives an abnormal cytology report at either the 12-month or 24-month follow-up, they must be referred to colposcopy NICE CKS.
- Reasons for Delaying Screening: Cervical screening should be delayed if the person is menstruating, less than 12 weeks post-partum, less than 12 weeks after a termination of pregnancy or miscarriage, pregnant, or has a vaginal discharge or pelvic infection (in which case the infection should be treated first) NICE CKS.