Page last updated: 25-AUG-2009

Cervical Screening

ONS kitemarkStatistical Publication Notice

25 August 2009

Scottish Cervical Screening Programme Statistics 2008/2009.

INTRODUCTION

Cervical screening was introduced in Scotland in the 1960s. Although large numbers of women were offered tests, the service at this time was not introduced as a population based programme. In 1978 committees were established by the UK Department of Health and a review was carried out in Scotland resulting in the Strong Report. In 1988/1989 NHS Boards and Trusts introduced computerised call/recall systems.
 
The national cervical screening programme was introduced in Scotland in 1988 with the aim of reducing the incidence of invasive cancer of the cervix. Cervical smears are routinely offered to eligible women aged 20-60 every three years. Women with an abnormal smear history will continue to be invited for follow-up as appropriate.

Cervical smears can identify pre-cancerous cell changes in women who otherwise have no symptoms; at this stage, any abnormalities can be easily treated, and treatment is usually very effective.

In May 2007, following a review of local call recall arrangements in Scotland, a new national IT system, the Scottish Cervical Call Recall System (SCCRS), was introduced across NHS Scotland.

The current release includes data to 31 March 2009.

KEY POINTS

At 31st March 2009:
  • Of eligible women, 73.4% had been screened in the previous 3.5 years, a rise of approximately 4% compared to 31st March 2008.
  • In contrast to 31st March 2008, uptake rates for those women invited to attend cervical screening in the previous 3.5 years have increased across all NHS Boards.
  • Of those women with a record of a previous smear taken within the last 3.5 years, uptake rates have improved across all five year age bands within the target age group of 20-60 years. When compared to 31st March 2008, the largest increase in uptake, of more than 6%, was found in the lowest age band of 20-24 years.
In 2008-09:
  • Over 450,500 cervical smears were processed within the programme, resulting in a 20% increase  (over 75,000 smears) from the previous year; the largest number of smears processed in any one year since 2001-02.
  • Of all the smears processed, 97% were satisfactory. Approximately 92% of satisfactory smears had a negative result and 3.5% had some degree of pre-cancerous change.

INTERPRETATION

Until 31st March 2009, uptake rates for those women invited to attend cervical screening in the previous 3.5 years had declined year on year across Scotland. The majority of the decrease, almost 7%, occurred between 31st March 2007 and 31st March 2008. This decline coincided with the implementation of a new standardised recording system, which has improved the quality of the data collected and could explain some of the decrease.

DETAILED FINDINGS

Women are invited to attend cervical screening once every three years. Of eligible women, 73.4% had been screened in the previous 3.5 years, a rise of approximately 4% compared to 31st March 2008.  In contrast to 31st March 2008, uptake rates have increased across all NHS Boards; the highest proportion was found in NHS Shetland, with a rate of 81.4%. The number of women attending cervical screening has also improved across all five year age bands within the target age group of 20-60 years; the largest increase, of more than 6%, was found in the lowest age band of 20-24 years. The rise in the number of women attending cervical screening most likely reflects the impact of the publicity surrounding Jade Goody’s death from cervical cancer.
 
Looking at the percentage uptake of those women who had a record of a previous smear taken in the last 5.5 years, all NHS Boards experienced a rise compared to 31st March 2008. Ten out of fifteen boards exceeded the NHS QIS Minimum Standard of >80%.
 
In 2008/09, over 450,500 cervical smears were processed within the programme, resulting in a 20% increase  (over 75,000 smears) from the previous year.
 
The percentage of unsatisfactory smears, where insufficient cells have been taken for testing, has fallen from 8.7% ten years ago to 3.0% in 2008-09. The main reason for this improvement is the introduction of a new method of processing smears (Liquid Based Cytology - LBC) during the screening year 2003-2004.  LBC reduces the rate of unsatisfactory smears and low grade smear results, and therefore the need for repeat smears.
 
The percentage of satisfactory smears showing some degree of pre-cancerous change has remained around 3-3.5% since 2000. The incidence of cancer of the cervix has shown a fairly stable (slightly decreasing) rate in the same time period.  Longer term, rates of cancer of the cervix have decreased by approximately 29% from 1997 to 2006. Over the last 25 years, European age-standardised rates have fallen from 14.7 per 100,000 in 1980 to 9.8 in 2006, as expected in the presence of a cancer screening programme.

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MAIN CONTACTS:

Donna Nicholson
Statistician
0141 282 2083
Donna.Nicholson@nhs.net

Nicola Clark
Statistician
0141 282 2018
NicolaClark4@nhs.net

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GLOSSARY:

cytology: the study of cells
dyskaryosis: abnormal cell changes
cervical smear: a test which detects abnormal changes in the cells of the cervix and enables affected women to have early treatment
adeno-carcinoma: a particular type of malignant tumour arising from glands
liquid based cytology (LBC): a method of assessing cell changes
satisfactory smear: a smear that is of sufficient quality that the diagnosis
given is likely to be correct
 
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PRE-RELEASE:

Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", ISD are obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access" refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.
 
Standard (five day) Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads
Scottish Cervical Screening Programme Health Board
Scottish Cervical Screening Programme Laboratories
Department of Public Health
 
 
Extended Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).
 
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HISTORY OF THIS PUBLICATION:

Last Published: 28 October 2008
Next Due: 31 August 2010
Data Available Since: Uptake data is available from 1995, workload data is fully available from 1999

 


Main contact: Email Donna Nicholson