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Published: 28 December 2023

New insights into cervical screening behaviour helps improve annual screening estimates

Our CervicalCheck programme moved to primary HPV cervical screening in 2020 and at the same time we raised the screening age range from 25-60 to 25-65.

The move to HPV testing involved changes to intervals between screening as follows:

  • women who were previously on a 3-year recall moved to a 5-year recall
  • women who have HPV found, but have no abnormal cells found, are called back after 1 year for another HPV screening test.

These changes are affecting how we estimate the numbers of women who are due a screening test each year and is resulting in fluctuations in the numbers actually attending for screening.

Other factors have also affected our modelling estimates in recent years:

  • the legacy of the extra 100,000 women who had out-of-cycle screening tests in 2018 which has significantly changed the recall dates for these women, bringing some back into the programme earlier than planned
  • the effect of COVID-19 on our services in 2020 and 2021, and the cyber-attack on the HSE in 2021, meant the number of women screened in those years varied considerably from month to month.

Our previous estimates had been based on modelling that looked at the historical activity of attendance for screening. This has been revised following an in-depth data analysis and estimates now include:

  • applied knowledge of women’s attendance following invite: 30% of women attend 6 months post invite and 40% attend within one year
  • better applied knowledge regarding behaviour of non-attenders following invite. All non- attenders and non-responders are not included in the total estimated forecast.

We’re now in our third year of HPV cervical screening and we’re gaining a better understanding of our programme data. This is improving our modelling for estimates, as follows:

  • We’re now better able to assess our recall rates and dates for those being invited for HPV cervical screening for the past 3 years and apply them to future years.
  • A dedicated resource was made available to analyse the data coming from the programme and this resulted in new insights into cervical screening behaviour.
  • The analysis of response rates from the first 3 years of HPV cervical screening allows for a better understanding of the behaviours behind attendances.
  • Given the high proportion of women now on 5-year recall after analysis, a reduction in women due for testing is to be expected and can be factored into future predictive models.
  • We now have the total 2020-2022 and most of 2023 figures to help us predict the invite and attendance rates more accurately for 2024 and following years.

We’ve revised our estimates for 2023 previously published in the HSE’s 2023 National Service Plan.

We expect that fluctuations will continue for a few more years as HPV testing settles into a normal routine and as we continue to improve our modelling based on new insights into screening behaviour.