By Micheál Rourke, CervicalCheck Data Analyst, National Screening Service
We’ve completed an analysis of data relating to women aged 63 to 69 who attended for HPV cervical screening with CervicalCheck as part of an equity-driven project. We reached women who had never been screened before due to strong stakeholder engagement, evidence-based communications and support from sample takers. The analysis shows that these women had higher rates of HPV and higher rates of high-grade abnormal cells than those with a history of previous screening.
Background
In 2023, we completed a project to invite women aged 63 to 69 to have a one-time CervicalCheck HPV screening test. These women did not have the opportunity to have an HPV screening test because they had already had their final cervical screening with the programme prior to 2020:
- before HPV screening was introduced
- before the upper age range for CervicalCheck was extended to 65.
We sent a bespoke invitation letter to 107,000 women on the CervicalCheck register who had previously had cytology screening only or who had never attended for screening. Over 30,000 of the women invited attended for an HPV screening test in the following 12 months.
What we did
We analysed our data to see how many women who had never previously attended for screening came for HPV screening in response to the one-time invitation. We then compared the screening results of these ‘never-screened’ women to the screening results of previously screened women aged 60 to 65 who attended for screening between April and September 2023.
What we found
The data shows that the 446 women who had never been screened before, and who responded to this invitation, had higher rates of HPV, higher rates of high-grade abnormal cells, and higher rates of referral to colposcopy clinics, than those who had attended for screening in the past.
- 7% of never-screened women tested positive for HPV compared to 4.7% of previously screened women.
- 1.3% of never-screened women had high-grade abnormal cells compared to only 0.2% of previously screened women.
- 3.4% of never screened women were referred to colposcopy clinics compared to 1.8% in the previously screened group.
- 40% of referrals to colposcopy in never-screened women were because of high-grade abnormal cell cytology results, compared to 13.1% in previously screened women.
What this tells us
This confirms that previous attendance at cervical screening reduces the risk of high-grade abnormal cells. It also emphasises the importance of screening at any age.
Next steps
We will do a further analysis of the data relating to HPV clearance rates and the colposcopy and histology outcomes for this group of women.