Population screening programmes – guidance

Cervical screening: programme overview

A description of the NHS cervical screening programme, including evidence on screening for cancer and HPV for women over 25.

Screening is the process of identifying individuals who appear healthy but may be at increased risk of a disease or condition.

The process is not perfect and in every screen there are a number of false positives and false negatives.

NHS cervical screening programme is available to women aged 25 to 64 in England.

All eligible women who are registered with a GP automatically receive an invitation by mail.

Women aged 25 to 49 receive invitations every 3 years. Women aged 50 to 64 receive invitations every 5 years.

NHS Choices provides information for the public on the cervical screening programme.

Evidence and recommendations

UK National Screening Committee (UK NSC) assesses evidence and makes recommendations to the 4 UK governments about population screening programmes.

UK NSC looked at the starting age for cervical cancer screening in 2012. They recommended not to invite women for cervical screening until the age of 25.

Evidence shows that the chance of developing cervical cancer if a woman has never had sex is low. If a woman is not currently sexually active but has been in the past, then the recommendation is that she continues screening

Screening tests

Cervical screening is a method of preventing cancer by detecting and treating abnormalities of the cervix.

Cervical cytology

The programme uses liquid based cytology (LBC) to collect samples of cells from the cervix.

The laboratory will examine these samples under the microscope to look for any abnormal changes in the cells.

Human papillomavirus

Human papillomavirus (HPV) is a common virus transmitted through sexual contact. In most cases, a woman’s immune system will clear the infection without the need for treatment.

HPV has over 100 subtypes, most of which do not cause significant disease in humans.

Known as high risk HPV (HR-HPV), some subtypes can cause cervical cancer. In particular HPV16 and HPV18.

Evidence has linked HR-HPV to the development of abnormal cervical cells. If left untreated, these abnormal cells may go on to develop into cervical cancer.

Early detection and treatment can prevent 75% of cancers developing.

HPV triage

If results show borderline or low grade abnormal cell changes (dyskaryosis), laboratories will perform an HR-HPV test.

Should the laboratory find HR-HPV, healthcare professionals should refer the woman for a colposcopy.

When HR-HPV is not detected, return women to routine screening.

HPV test of cure

HPV test of cure (TOC) uses HR-HPV testing to assess women who have received treatment for :

  • cervical intra epithelial neoplasia (CIN)
  • cervical glandular intra epithelial neoplasia (CGIN)

Healthcare professionals should use the TOC pathway to decide if the woman needs either:

  • referral for further assessment
  • recall for screening in 3 years

Vaccinated women

The HPV vaccination programme started in 2008. Vaccinations will not have an impact on incidence for many years; vaccinated women should continue accepting offers of cervical screening.

Providing prompt care

Healthcare professionals must use the cervical screening professional documents to ensure they follow the correct protocols and processes .


All commissioners must follow the service specification and supporting document to ensure a fit for purpose programme is set up and is meeting the standards set by the national screening programme.

Contact the screening team

NHS cancer screening programmes

Fulwood House
Old Fulwood Road

S10 3TH