Reasons for attending cervical screening

In England, Northern Ireland and Wales all women between the ages of 25 and 64 are eligible for a free cervical screening test every 3 or 5 years, depending on their age. Women living in Scotland between the ages of 20 and 60 are invited for a test every 3 years, although this is due to change in 2016 to between the ages of 25 and 64, in line with the rest of the country.

In the light of evidence published in 2003 *1  the NHS Cervical Screening Programme in England now offers screening at different intervals depending on age. This means that women are provided with a more targeted and effective screening programme. The intervals are:
Age group (years)
Frequency of screening
25
First invitation
25–49
3 yearly
50–64
5 yearly
65+
Only screen those who have not been screened since age 50 or have had recent abnormal tests’
– from NHS Cervical Screening Programme: About cervical screening.

Why are women under 25 not invited?

Cervical cancer is very rare in women under 25 (64 cases per 100,000 women 2*) but cervical abnormalities linked to HPV infection are very common in women under 25. In most cases abnormalities in young women go away by themselves and do not need any treatment (see our section on ‘HPV‘ for more information). If those under 25 were screened many would test positive for abnormalities and would be sent for unnecessary treatment to remove the affected cells. This treatment may increase the risk of a woman having a pre-term delivery (giving birth before 37 weeks) if she goes on to have children and the whole process can cause lots of anxiety and worry. So it is thought that it does more harm than good to screen women under the age of 25. If a woman under 25 has symptoms such as bleeding after sex or unusual bleeding (not during her period) she should see her GP for advice and this should be investigated (see NHS Clinical Practice Guidance for the Assessment of Young Women aged 20–24 with abnormal vaginal bleeding)

The NHS Cervical Screening Programme routinely invites women who are registered with a GP. Women who have not had a recent test may be offered one when they attend their GP or family planning clinic on another matter.

In our interviews we asked women why they go for a cervical screening test.

Many women said they have a regular test to enable any changes in their cervix to be detected early and treated before they became more serious. Reassurance that they are well and their cervix is healthy gives them peace of mind.

She has regular cervical screening tests so that any changes are detected early.

Age at interview 34

Gender Female

Age at diagnosis 34

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She believes it would be much worse to find out you have cervical cancer and to know that you…

Age at interview 52

Gender Female

Age at diagnosis 46

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Tina goes for screening because its a two minute procedure to know that she is healthy.

Age at interview 41

Gender Female

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Several women considered cervical screening to be a painless and short procedure with many important benefits. A few compared cervical screening to going to the dentist on a regular basis; both were considered to be important aspects of preventative health care. Others believed they had a responsibility to themselves to take up the opportunity of screening and to keep themselves healthy.

Women who went regularly for cervical screening believed it is too important for women to be put off by embarrassment or discomfort.

Regular cervical screening is important in preventing cervical cancer.

Age at interview 52

Gender Female

Age at diagnosis 37

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Cervical screening is an important part of looking after yourself.

Age at interview 48

Gender Female

Age at diagnosis 48

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Others felt an obligation to attend for cervical screening. Some of these women were influenced by pressure or advice from family and friends. A few said they felt guilty if they did not attend for cervical screening.

She put off having cervical screening until she was forty because she was too scared to go for a test. But…

Age at interview 54

Gender Female

Age at diagnosis 54

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Some women undergo regular cervical screening tests for reassurance that they are well and their cervix is healthy.

Its important to go for cervical screening so that if any changes are found, they can be caught…

Age at interview 43

Gender Female

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A few attended regularly for cervical screening because they believed they might be vulnerable to cervical changes because a relative had had cervical problems. There is no medical evidence that abnormal cervical cells or cervical cancer is hereditary.

HPV is a very common infection of the cervix and medical evidence suggests that some types of HPV, which is a sexually transmitted virus, are a major risk factor for cervical cancer. HPV is thought to cause 99.7% of cervical cancers. 3*

For more information see ‘Human papilloma virus (HPV)’ in our ‘Cervical abnormalities: CIN3 and CGIN section or ‘Ideas about causes of cervical cancer’ in our ‘Cervical cancer‘ section.

1* P Sasieni, J Adams and J Cuzick, Benefits of cervical screening at different ages: evidence from the UK audit of screening histories, British Journal of Cancer, July 2003

2* Cancer Research UK. Cervical cancer incidence statistics. Accessed: October 2015.

3* Walboomers JMM et al. (1999) Human papilloma virus is a necessary cause of invasive cancer worldwide. Journal of Pathology, 189 (1), 12-19.

Experiences of cervical screening

Cervical screening is not a test for cancer. It is a test to check the health of the cervix. Cervical screening is a method of...