Cervical screening standards data report 2021 to 2022
Published 25 April 2023
Applies to England
© Crown copyright 2023
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In this report we use ‘screening year 2021 to 2022’ to refer to 1 April 2021 to 31 March 2022. See more information about the terminology used in this report in Section 5.
This report focuses on performance in England from 1 April 2021 to 31 March 2022 compared to the national cervical screening programme standards but also includes trend data from previous years where this is available.
These standards contribute to assessing the quality of the cervical screening programme (CSP) across England. Publishing the data ensures stakeholders and the public have access to reliable and timely information on the quality and performance of the screening programme.
The standards focus on some of the important targets providers have to meet and maintain to make sure local screening services are high quality, safe and effective.
This report provides data on coverage, timeliness of receiving results, laboratory and colposcopy clinical standards.
Where the data show that standards are not met or there are data collection issues, providers and commissioners should ensure appropriate action is taken to address the issue. Within NHS England, the Public Health Commissioning and Operations team works with the Screening Quality Assurance Service (SQAS) to provide advice and support to this process .
The data in this report complements that published jointly by NHS Digital and NHS England in the annual cervical screening statistical bulletin for 2021 to 2022. The coverage data in this report differs slightly to the statistical bulletin because it is based on clinical commissioning group (CCG) rather than local authority . The number of CCGs reduced from 135 to 106 from April 2021.
The report covers the second full year of HPV primary screening since the implementation of the new screening pathway in December 2019.
1. Coverage
This section covers standards CSP-S01 and CSP-S02.
We measure coverage in the national screening programmes to provide assurance that screening is being offered to the eligible population.
Eligible individuals are those entitled to an offer of screening. For cervical screening, this is individuals aged from 24 years and 6 months up to 64 years, who have a cervix . Details of specific definitions used to extract the data are shown in Section 5 .
Coverage is an important indicator for the programme to achieve its aims of reducing incidence and mortality.
CSP-S01: coverage for women aged 25 to 49 years
68.6% of women in the registered population eligible for cervical screening aged 25 to 49 at the end of the period reported were screened adequately within the previous 3 and a half years (where the eligible population is 10,408,742).
| Region | Women aged 25 to 49 (%) |
|---|---|
| England | 68.6 |
| East of England | 71.4 |
| London | 61.2 |
| Midlands | 69.6 |
| North East and Yorkshire | 71.8 |
| North West | 69.4 |
| South East | 70.2 |
| South West | 72.3 |
Figure 1: Cervical screening – coverage performance, for women aged 25 to 49, England, as at 31 March 2022 .
Coverage for those aged 25 to 49 is historically lower than for those aged 50 to 64 (see standard S02 below).
Figure 2: CSP-S01: coverage for women aged 25 to 49, England, screening year ending March 2017 to the year ending March 2022
The line graph above shows a slight decrease from 69.7% to 69.4% over the screening years ending March 2017 to 2018,increasing to 70.9% in the screening year ending March 2020 before a decrease to 68.6% in the screening year ending March 2022.
Figure 3: CSP-S01: map of coverage for women aged 25 to 49, England, as at 31 March 2022
The map above shows that at March 2022, none of the 106 clinical commissioning groups (CCGs) in England met or exceeded the 80% acceptable threshold.
CSP-S02: Coverage for women aged 50 to 64 years
75.0% of women in the registered population eligible for cervical screening aged 50 to 64 at end of period reported who were screened adequately within the previous 5 and a half years (where the eligible population is 5,315,681).
| Region | Women aged 50 to 64 (%) |
|---|---|
| England | 75.0 |
| East of England | 76.3 |
| London | 71.8 |
| Midlands | 75.5 |
| North East and Yorkshire | 76.3 |
| North West | 74.0 |
| South East | 75.2 |
| South West | 76.2 |
Figure 4: Cervical screening – coverage performance, for women aged 50 to 64, England, as at 31 March 2022 .
Coverage for those aged 50 to 64 has historically been higher than for younger women (see standard S01 above).
Figure 5: CSP-S02: Coverage for women aged 50 to 64, England, screening year ending 2017 to the year ending March 2022
The line graph above shows a decrease from 77.3% to 76.3% over the screening years ending 2017 and 2018 and then remains at 76.4% for the screening years ending 2019 and 2020. The graph then decreases to 75.0% in the screening years ending in 2021 and 2022.
Figure 6: CSP-S02: map of coverage for women aged 50 to 64, England, as at 31 March 2022 .
The map above shows that at March 2022, none of the 106 clinical commissioning groups (CCGs) in England met or exceeded the 80% acceptable threshold.
2. Test – timely receipt of result letter
This section covers standard CSP-S03. This standard covers the screening pathway from the date the sample is taken to the expected date the result letter is received .
We measure timely receipt of result letter to monitor that the outcome of the screening test is communicated to participants promptly.
CSP-S03: test – timely receipt of result letter
79.6% of women recorded on the cervical screening call and recall IT system received their screening results in writing within 14 days from the date of their screening sample being taken (where the number of result letters sent was 3,384,829).^ Section 5 gives further details of who is recorded on the call and recall IT system.
| Region | Results received within 14 days (%) |
|---|---|
| England | 79.6 |
| East of England | 89.4 |
| London | 85.8 |
| Midlands | 60.5 |
| North East and Yorkshire | 81.2 |
| North West | 66.4 |
| South East | 97.2 |
| South West | 81.3 |
Figure 7: Cervical screening – receiving results within 14 days, England, screening year 2021 to 2022
This standard is affected by transport of samples, reporting times in laboratories and result letter administration by the call and recall service.
HPV primary screening was implemented across England in December 2019. This affected the whole screening pathway while planning for the change took place. It meant the standard of at least 98% of women receiving their results within 14 days of their test being taken was not met. Since the implementation of HPV primary screening, performance against this standard has significantly improved, although still does not yet meet the minimum level required.
Figure 8: CSP-S03: Percentage of women receiving their result within 14 days of their test, England, screening year ending March 2016 to the year ending March 2022
Line graph showing a steady decrease from 89.1% to 44.0% in years 2019 to 2020 before a large increase to 79.6% in screening year ending 2022.
Figure 9: CSP-S03: map of women receiving their result within 14 days, England, screening year 2021 to 2022
The map above shows that in the screening year 2021 to 2022 , only one of the 106 clinical commissioning groups (CCGs) in England met or exceeded the 98% acceptable threshold. This is most likely to be due to continuing recovery after the COVID-19 pandemic.
3. Laboratory standards
This section covers standards CSP-S04, CSP-S05, CSP-S06 and CSP-S07.
Laboratories provide data using the mandatory KC61 return apart from CSP-S04 which uses a special data request. Following the implementation of HPV primary screening in December 2019, there are now 8 cervical screening laboratories in England compared to 48 prior to December 2019. The screening year ending in March 2022 is the second full year of HPV primary screening data collected from these 8 laboratory services.
Standards CSP-S06 and CSP-S07 rely on data from the previous screening year and are calculated using data from the 8 laboratories operating during the screening year ending March 2022.
CSP-S04: test – minimise false negative reporting
97.6% of all cytology abnormalities (and 98.7% of high grade cytology abnormalities) were correctly identified at the initial review when compared with the results of a second, ‘rapid’ review (where the number of abnormal samples was 179,324 and the number of high grade abnormalities was 42,429).
| Region | proportion of abnormal samples correctly identified (%) | proportion of high grade samples correctly identified (%) |
|---|---|---|
| England | 97.6 | 98.7 |
| East of England | 97.4 | 98.7 |
| London | 97.1 | 97.9 |
| Midlands | 98.0 | 98.8 |
| North East and Yorkshire | 98.4 | 99.5 |
| North West | 99.0 | 99.4 |
| South East | 97.4 | 98.9 |
| South West | 95.2 | 97.3 |
Figure 10: Cervical screening – proportion of samples correctly identified at the initial review, England, screening year 2021 to 2022
Standard CSP-S04, known as ‘sensitivity’, measures the proportion of all cytology abnormalities or high grade cytology abnormalities that were correctly identified at the initial review when compared with the results of a second, ‘rapid’ review. This standard is important to monitor to help reduce the chance of abnormalities not being detected. The change to HPV primary screening has resulted in a small increase in sensitivity. This is likely to be because only screening samples that are known to be HPV positive receive a cytology review.
Figure 11a: CSP-S04: proportion of samples correctly identified at the initial review (all abnormalities), England, screening year ending 2018 to the year ending March 2022
The line graph for all abnormalities (above) is generally steady at between 96.3% to 96.7% over the screening years ending March 2018 to 2020. There has been a slight increase to 97.6% in the screening year 2021 to 2022.
Figure 11b: CSP-S04: proportion of samples correctly identified at the initial review (high grade abnormalities), England, screening years ending 2018 to 2022
The line graph for high grade abnormalities (above) shows a steady increase from 97.9% to 98.7% over screening years March 2018 to 2022.
All 8 cervical screening laboratories met or exceeded the standard for all abnormalities and for high grade abnormalities.
CSP-S05: test – inadequate samples
0.54% of cervical screening samples were reported as HPV unavailable or cytology inadequate (where the total number of samples reported was 3,368,473), compared with 0.40% in the screening year ending March 2021.
| Region | Inadequate samples as % |
|---|---|
| England | 0.54 |
| East of England | 0.21 |
| London | 1.03 |
| Midlands | 0.28 |
| North East and Yorkshire | 0.34 |
| North West | 0.31 |
| South East | 0.58 |
| South West | 1.09 |
Figure 12: Cervical screening – proportion of samples reported as inadequate, England, screening year 2021 to 2022
The inadequate rate is reported for samples received from women aged 25 to 64 taken at a GP practice or community clinic .
Rates should be low as tests reported as inadequate need to be repeated to get a result for the participant. However, some inadequate results are expected due to technical or administrative reasons.
Prior to the screening year ending in March 2021, this standard was measured by calculating a 5% to 95% ‘acceptable’ range annually from the rates for all laboratories. As there are now only 8 laboratories, this is no longer an appropriate method to calculate a standard range. Whilst the method for calculating a standard is being reviewed, the range will be reported. The Section 7a Public Health Commissioning and Operations team with Screening Quality Assurance Service (SQAS) and commissioners will continue to monitor trends in the rate of inadequate tests but will not apply a standard.
The minimum rate reported was 0.21%.
The maximum rate reported was 1.09%.
Figure 13: CSP-S05: Proportion of samples reported as inadequate, England, screening year ending March 2016 to the year ending March 2022
The line graph above shows an increase from 2.5% to 2.7% over the screening years ending March 2016 to 2017. It then shows a decrease to 2.3% in the screening year ending March 2019 before a large decrease to 0.4% in the screening year ending March 2021. This is followed by a slight increase to 0.5% in screening year 2021 to 2022. The large decrease is likely due to the benefits of the roll out of HPV primary testing. HPV testing is more likely to obtain an adequate result than cytology and as all cytology samples tested are known to be HPV positive, there is less chance of an inadequate cytology result.
CSP-S06: test – cytological positive predictive value (PPV)
82.0% of participants referred with high grade abnormalities who have a histological outcome of cervical intraepithelial neoplasia (CIN) 2, CIN 3, cervical glandular intraepithelial neoplasia (CGIN) (adenocarcinoma in situ) or cervical cancer (where the number of people referred whose histology outcome was no abnormality detected (NAD) or worse was 31,262), compared with 82.5% in the screening year ending March 2021 .
| Region | positive predictive value as % |
|---|---|
| England | 82.0 |
| East of England | 84.8 |
| London | 76.1 |
| Midlands | 87.3 |
| North East and Yorkshire | 76.3 |
| North West | 88.1 |
| South East | 82.0 |
| South West | 87.6 |
Figure 14: Cervical screening – proportion of high grade referrals with histology of CIN 2 or worse, England, screening year 2021 to 2022
PPV reports the correlation between a high grade cytology screening result and the subsequent histological outcome for those referred to colposcopy in the 12 months prior to the year reported.
Cytology is partly subjective and may be overcalled. PPV can be further influenced by histological diagnosis and colposcopy practice and disease prevalence. Calculating a range means that some laboratories will be outside the standard (above or below) and this would warrant further investigation.
Prior to the screening year ending in March 2022, this standard was measured by calculating a 5% to 95% ‘acceptable’ range annually from the rates for all laboratories. As there are now only 8 laboratories, this is no longer an appropriate method to calculate a standard range. Whilst the method for calculating a standard is being reviewed, the range will be reported. Within NHS England, the Public Health Commissioning and Operations team, Screening Quality Assurance Service (SQAS) and regional public health commissioners will continue to monitor trends in the PPV rate but will not apply a standard.
The minimum rate reported was 76.1%.
The maximum rate reported was 88.7%.
Figure 15: CSP-S06: proportion of high grade referrals with histology of CIN 2+, England, screening year ending March 2016 to the screening year ending March 2022
The line graph above is generally steady at between 85.4% to 85.2% over the screening years ending March 2016 to 2019, before a steady decrease to 82.0% in the year ending March 2022.
CSP-S07: test – cytological abnormal predictive value (APV)
11.8% of participants referred with borderline or low grade cytology results who have a histological outcome of CIN 2, CIN 3, CGIN (adenocarcinoma in situ) or cervical cancer (where the number of people referred whose histology outcome was no abnormality detected (NAD) or worse was 96,544), compared to 13.1% in the screening year ending March 2021.
| Region | Abnormal predictive value as % |
|---|---|
| England | 11.8 |
| East of England | 11.5 |
| London | 11.7 |
| Midlands | 13.6 |
| North East and Yorkshire | 10.2 |
| North West | 10.4 |
| South East | 10.4 |
| South West | 18.4 |
Figure 17: Cervical screening – proportion of low grade referrals with histology of CIN 2 or worse, England, screening year 2021 to 2022
Abnormal predictive value (APV) reports the correlation between low grade cytology screening results and the subsequent histological outcome for people referred to colposcopy in the 12 months prior to the year reported. A small proportion of low grade screening results are expected to be found to have a high grade histology outcome.
Cytology is partly subjective and may be under-called. APV can be further influenced by histological diagnosis and colposcopy practice.
Prior to the screening year ending in March 2022, this standard was measured by calculating a 5% to 95% ‘acceptable’ range annually from the rates for all laboratories. As there are now only 8 laboratories, this is no longer an appropriate method to calculate a standard range. Whilst the method for calculating a standard is being reviewed, the range will be reported. Within NHS England, the Public Health Commissioning and Operations team, Screening Quality Assurance Service (SQAS) and regional public health commissioners will continue to monitor trends in the APV rate but will not apply a standard.
The minimum rate reported was 10.2%.
The maximum rate reported was 18.4%.
Figure 18: CSP-S07: proportion of low grade referrals with histology of CIN 2 or worse, England, screening year ending March 2016 to the screening year ending March 2022
The line graph above shows a decrease from 16.9% in the screening year ending March 2016 to 11.8% by the year ending March 2022. This shows that over time low grade referrals are less likely to have a high grade histology outcome.
4. Colposcopy standards
This section covers standards CSP-S08, CSP-S09, CSP-S10, CSP-S11 and CSP-S12.
Colposcopy clinics provide data using the mandatory KC65 return apart from CSP-S09 which uses a special data request.
In the screening year ending March 2022, 186 colposcopy clinics returned data for the majority of the standards (compared to 192 the year before). This reduction can be attributed to the residual effect of the COVID-19 pandemic on some clinic sites which remained closed .
CSP-S08: colposcopy – timely biopsy result letter sent
81.3% of individuals received their biopsy results within 4 weeks of the sample being taken (the acceptable threshold is 90% and above) and 98.0% received their results within 8 weeks (the achievable threshold is 100%). The number of results overall was 53,520. This compares to 86.0% and 98.3% respectively for the same standards in the screening year ending March 2021.
| Region | Proportion received within 4 weeks (%) | Proportion received within 8 weeks (%) |
|---|---|---|
| England | 81.3 | 98.0 |
| East of England | 91.1 | 99.6 |
| London | 85.9 | 98.9 |
| Midlands | 84.1 | 97.6 |
| North East and Yorkshire | 77.1 | 97.1 |
| North West | 74.8 | 96.8 |
| South East | 67.8 | 96.8 |
| South West | 83.9 | 98.7 |
Figure 20: Cervical screening – proportion of biopsy results received within 4 or 8 weeks, England, screening year 2021 to 2022
This standard is important to ensure results of biopsies (diagnostic or treatment) are received in a timely manner. This ensures that those who require further treatment and those who do not are informed in writing at the earliest opportunity. Achievement of this standard is influenced by the timeliness of histology reporting and the efficiency of colposcopy clinic administration.
For results received within 4 weeks, the minimum rate reported was 19.6%.
For results received within 8 weeks, the minimum rate reported was 81.6%.
The data show that 87 of 186 clinics reported at least 90% of results were received within 4 weeks, and 86 of 186 reported all results were received within 8 weeks.
Figure 21a: CSP-S08: proportion of results received within 4 weeks, England, screening year ending 2016 to the screening year ending March 2022
The line graph above shows an increase from 83.2% to 86.2% over the screening years ending 2016to 2018, before a decrease to 81.8% over the screening years ending 2019 and 2020. It then shows an increase to 86.0% in the screening year ending 2021 before a decrease to 81.3% in screening year ending 2022.
Figure 21b: CSP-S08: proportion of results received within 8 weeks, England, screening year ending 2016 to the screening year ending March 2022
The line graph above shows generally steady performance from 97.9% in the screening year ending March 2016 to 98.0% in the screening year ending March 2022. It reached a maximum of 98.8% in the screening year ending March 2017 and a low of 97.9% in the screening year ending March 2016.
| Region | Performance < acceptable | Acceptable range | Total |
|---|---|---|---|
| East of England | 8 | 12 | 20 |
| London | 13 | 13 | 26 |
| Midlands | 17 | 19 | 36 |
| North East and Yorkshire | 23 | 13 | 36 |
| North West | 14 | 8 | 22 |
| South East | 14 | 7 | 21 |
| South West | 9 | 15 | 24 |
Figure 22: CSP-S08: Received within 4 weeks, number of clinics below or within the acceptable range and the total, by region, screening year 2021 to 2022
| Region | Performance < acceptable | Acceptable range | Total |
|---|---|---|---|
| East of England | 8 | 12 | 20 |
| London | 16 | 10 | 26 |
| Midlands | 14 | 22 | 36 |
| North East and Yorkshire | 21 | 15 | 36 |
| North West | 16 | 6 | 22 |
| South East | 15 | 6 | 21 |
| South West | 9 | 15 | 24 |
Figure 23: CSP-S08: Received within 8 weeks, number of clinics below or within the achievable range and the total, by region, screening year 2021 to 2022.
CSP-S09: colposcopy – intervention or treatment (12-month follow-up after treatment)
2.9% of individuals seen at colposcopy within 12 months of previous treatment had a histology result of CIN or cancer (the acceptable threshold is 5.0% and under), where the number returning to colposcopy after treatment was 36,984. This compares to 2.9% in the screening year ending March 2021.
| Region | Proportion with CIN or cancer (%) |
|---|---|
| England | 2.9 |
| East of England | 4.3 |
| London | 3.7 |
| Midlands | 2.2 |
| North East and Yorkshire | 2.1 |
| North West | 1.9 |
| South East | 2.3 |
| South West | 4.6 |
Figure 24: Cervical screening – proportion of individuals with CIN or cancer within 12 months of previous treatment, England, screening year 2021 to 2022
It is important to maximise successful treatment to ensure that the number of individuals with residual high grade disease or cancer within 12 months of treatment is as low as possible.
Not all clinics could supply data for this standard – 172 of 183 clinics returned figures. This is an improvement from the screening year ending March 2021 where 161 clinics returned data. Services and commissioners are responsible for taking action to ensure accurate and complete data are reported from all clinics.
The minimum rate reported was 0%.
The maximum rate reported was 10.4%.
Figure 25: CSP-S09: proportion of individuals with CIN or cancer within 12 months, England, screening years ending March 2018 to 2022
The line graph above shows a slight increase from 2.8% to 2.9% over the screening years ending March 2018 to screening year ending March 2019, then remaining steady at 2.9% to screening year ending March 2022.
| Region | Acceptable range | Performance > acceptable | Total |
|---|---|---|---|
| East of England | 13 | 7 | 20 |
| London | 18 | 6 | 24 |
| Midlands | 32 | 2 | 34 |
| North East and Yorkshire | 26 | 3 | 29 |
| North West | 21 | 0 | 21 |
| South East | 20 | 1 | 21 |
| South West | 14 | 9 | 23 |
Figure 26: CSP-S09: proportion of individuals with CIN or cancer within 12 months, number of clinics within or above the acceptable range and the total, by region, screening year 2021 to 2022
CSP-S10: colposcopy – intervention or treatment (inadequate cytology)
75.5% of individuals referred for colposcopy after 2 consecutive inadequate cytology or HPV unavailable screening tests were offered an appointment within 6 weeks of referral (the acceptable threshold is at least 99%). The overall number of inadequate referrals was 1,436. This compares to 72.7% for the screening year ending in March 2021. The lower percentage against the standard is a result of the impact of the COVID-19 pandemic continuing to affect the capacity of clinics to offer appointments.
| Region | proportion offered an appointment within 6 weeks (%) |
|---|---|
| England | 75.5 |
| East of England | 62.9 |
| London | 59.8 |
| Midlands | 87.3 |
| North East and Yorkshire | 71.0 |
| North West | 86.2 |
| South East | 53.4 |
| South West | 94.3 |
Figure 27: Cervical screening – inadequate referrals offered a colposcopy appointment within 6 weeks, England, screening year 2021 to 2022
Standard CSP-10 is important to ensure that individuals have prompt referral for colposcopy assessment to reduce anxiety, and to make sure that no abnormality is missed and a definitive screening result is achieved.
This standard covers individuals referred to colposcopy following persistent inadequate cytology or unavailable HPV result, with the most recent result being inadequate cytology.
Not all clinics reported receiving inadequate referrals – 160 of 186 clinics had referrals in this category. The remaining 26 reported no inadequate referrals during the time period.
The minimum rate reported was 3.6%.
The data show that 90 of 160 clinics reported that all inadequate referrals were offered an appointment within 6 weeks.
Figure 28: CSP-S10: inadequate referrals offered a colposcopy appointment within 6 weeks, England, screening year ending March 2018 to the year ending March 2022
The line graph above shows a slight decrease from 95.2% to 93.8% over the screening years ending March 2018 to 2020. A large decrease to 72.7% in the screening year ending March 2021 is followed by an increase to 75.5% in screening year ending March 2022.
| Region | Performance < acceptable | Acceptable range | Total |
|---|---|---|---|
| East of England | 4 | 11 | 15 |
| London | 16 | 6 | 22 |
| Midlands | 9 | 19 | 28 |
| North East and Yorkshire | 14 | 17 | 31 |
| North West | 7 | 15 | 22 |
| South East | 12 | 6 | 28 |
| South West | 8 | 16 | 24 |
Figure 29: CSP-S10: inadequate referrals offered a colposcopy appointment within 6 weeks, number of clinics below or within the acceptable range and the total, by region, screening year 2021 to 2022
CSP-S11: colposcopy – intervention or treatment (6-week appointment)
75.5% of individuals referred for colposcopy after a positive high risk human papillomavirus (HR-HPV) test with negative or borderline or low-grade dyskaryosis cytology were offered an appointment within 6 weeks of referral (the acceptable threshold is 99%). The overall number of these referrals was 147,921. This compares to 72.5% in the screening year ending March 2021. The lower percentage against the standard is a result of the impact of the COVID-19 pandemic continuing to affect the capacity of clinics to offer appointments.
| Region | proportion offered appointment within 6 weeks (%) |
|---|---|
| England | 75.5 |
| East of England | 78.4 |
| London | 69.9 |
| Midlands | 86.7 |
| North East and Yorkshire | 73.9 |
| North West | 77.3 |
| South East | 54.6 |
| South West | 87.8 |
Figure 30: Cervical screening – offered a colposcopy appointment within 6 weeks of referral due to a positive HR-HPV test and negative or borderline or low-grade dyskaryosis cytology, England, screening year 2021 to 2022
Standard CSP-S11 is important to ensure that individuals are seen within 6 weeks of their abnormal screening result for further assessment. This ensures timely management and reduces anxiety.
In the screening year 2021 to 2022, referrals due to positive high-risk HPV (HR-HPV) with a negative cytology result are recorded in the ‘other’ referral indication category alongside the small number of referrals not due to a screening abnormality or clinical indication. Clinics were only able to report the ‘other’ category as a whole and this was taken as an indication for HR-HPV positive with negative referrals. It is therefore possible that actual practice is better than the performance reported here.
The minimum rate reported was 7.5%.
The data show that 45 of 186 clinics reported all such referrals were offered an appointment within 6 weeks.
Figure 31: CSP-S11: individuals offered a colposcopy within 6 weeks of referral due to a positive HR-HPV test and negative or borderline or low-grade dyskaryosis cytology, England, screening year ending March 2018 to the screening year ending March 2022
The line graph above shows a slight decrease from 95.8% to 93.0% over the screening years ending March 2018 to 2020. A large decrease to 72.5% in the screening year ending March 2021 is followed by an increase to 75.5% in the screening year ending March 2022.
| Region | Performance < acceptable | Acceptable range | Total |
|---|---|---|---|
| East of England | 13 | 7 | 20 |
| London | 18 | 8 | 26 |
| Midlands | 27 | 9 | 36 |
| North East and Yorkshire | 32 | 5 | 37 |
| North West | 15 | 7 | 22 |
| South East | 21 | 0 | 21 |
| South West | 15 | 9 | 24 |
Figure 32: CSP-S11: HPV positive referrals offered appointment within 6 weeks, number of clinics below or within the acceptable range, by region, screening year 2021 to 2022
CSP-S12: colposcopy – intervention or treatment (2-week appointment)
93.9% of individuals referred for colposcopy after a cytological report of high grade dyskaryosis (moderate) or worse were offered an appointment within 2 weeks of referral (the acceptable threshold is 93%). The overall number of such referrals was 37,042. This is slightly higher than the 93.2% reported in the screening year ending March 2021.
| Region | proportion offered appointment within 2 weeks (%) |
|---|---|
| England | 93.9 |
| East of England | 95.6 |
| London | 95.8 |
| Midlands | 90.1 |
| North East and Yorkshire | 94.9 |
| North West | 95.5 |
| South East | 91.1 |
| South West | 92.7 |
Figure 33: Cervical screening – individuals offered a colposcopy within 2 weeks of referral due to a high grade (moderate dyskaryosis or worse) cytology result, England, screening year 2021 to 2022
Standard CSP-S12 is important to ensure that individuals are seen within 2 weeks of a high grade abnormal result for further assessment to ensure timely management and to reduce anxiety.
The minimum rate reported was 36.6%.
The data show that 140 of 186 clinics reported all high grade referrals were offered an appointment within 2 weeks.
Figure 34: CSP-S12: individuals offered a colposcopy within 2 weeks of a cytological report of high grade dyskaryosis (moderate) or worse, England, screening year ending March 2016 to the year ending March 2021
The line graph above shows generally steady performance from 95.0% in the screening year ending March 2017 to 93.9% in the screening year ending March 2022. It reached a maximum of 96.0% in the screening year ending March 2018 and a low of 93.2% in the screening year ending March 2021.
| Region | Performance < acceptable | Acceptable range | Total |
|---|---|---|---|
| East of England | 3 | 17 | 20 |
| London | 5 | 21 | 26 |
| Midlands | 13 | 23 | 36 |
| North East and Yorkshire | 9 | 28 | 37 |
| North West | 4 | 18 | 22 |
| South East | 5 | 16 | 21 |
| South West | 7 | 17 | 24 |
Figure 35: CSP-S12: high grade referrals offered a colposcopy appointment within 2 weeks, number of clinics below or within the acceptable range and the total, by region, screening year 2021 to 2022
5. Terminology
The NHS Cervical screening Programme is offered to women and people with a cervix between the ages of 24 years and 6 months and 64 years. Over 3 million people are tested in England every year. Within this report, where the term “women” is used, this means women and people with a cervix .
The cervical screening programme sends invitations to patients who are registered as female or indeterminate. If a person has changed their gender registered on their primary care medical records to male, they will no longer automatically receive invitations from the programme, however, they remain eligible to have screening if they have a cervix. The screening should be organised from the GP practice who would take on the responsibility for inviting for screening at the required screening intervals.
Cervical intraepithelial neoplasia (CIN) is the medical term for abnormal cells in the cervix. CIN is not cancer, but it can sometimes go on to develop into cancer.
CIN is graded CIN 1, 2 or 3, where:
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CIN 1 (low grade) means the abnormality is unlikely to develop into cancer as the cells will often go back to normal on their own
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CIN 2 or 3 (high grade) means there is a greater chance the cells could develop into cancer; women with CIN 2 or 3 are usually offered treatment
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Cervical glandular intraepithelial neoplasia (CGIN), also known as adenocarcinoma in situ, is an abnormality of the glandular tissue in the cervix; for any grade of CGIN, treatment will be offered
Information about cervical screening standards and service specifications is available.