By Dr Therese McGlacken, Specialist Registrar in Public Health Medicine, National Screening Service
We provide cervical screening for women and people with a cervix aged 25 to 65. Cervical screening is a test for the human papillomavirus (HPV) – a virus that can cause changes to the cells in the cervix which could develop into cervical cancer if left untreated. The test looks for high-risk types of HPV which cause most cervical cancers.
Finding cell changes at an early stage allows for timely intervention and treatment, and better health outcomes. We screen women up to age 65, which is in line with international best practice guidelines to maximise the benefits of cervical screening, while minimising the potential harms.
Research shows that the benefits of cervical screening decline with age. The harms - such as false positives and unnecessary treatments - become more common. This is because the risk of cervical cancer decreases with age, particularly for women have never had a positive HPV result or abnormal cells found.
As changes to cervical cells happen slowly - typically taking 15 to 20 years for cells to go from normal to abnormal to cancer - the likelihood of cervical cancer developing in older age is low. This means that the harms of continued screening beyond the age of 65 outweigh the potential benefits. When harms outweigh benefits, best practice in cancer screening programmes is clear – we should not offer programmatic screening.
Each year, about 250 women in Ireland are diagnosed with cervical cancer, and around 90 lives are lost to the disease. Now, combining the HPV vaccine and cervical screening, we are seeing significant progress in reducing the number of cervical cancer cases.
We continuously review new research and international guidelines to make sure our CervicalCheck programme provides the highest quality evidence-based screening service. Any changes to the age range must be based on strong scientific evidence showing that the benefits outweigh the harms.
How does Ireland compare to other countries?
Most high-income countries, including Ireland, England and Scotland, stop cervical screening between the ages of 60 and 69. Some countries, such as Australia and South Korea, continue screening beyond 70. These countries often base this decision to continue screening on individual risk factors, such as HPV vaccination status and personal medical history.
The importance of attending screening
Cervical screening helps prevent cervical cancer by detecting high-risk HPV, which can lead to abnormal cell changes. This allows for early intervention when treatment is most effective.
Screening is effective at identifying women at the highest risk of developing cervical cancer. Attending cervical screening when invited is the best way to benefit from it. If you have never had cervical screening, consider taking up the offer of free cervical screening before you turn 65 — it is a simple and effective way to reduce your risk of developing cervical cancer.
Know the symptoms: Screening is not a diagnostic test
Cervical screening is for women who have no symptoms of cervical cancer. It helps to identify those who may be at risk of developing cervical cancer - it does not diagnose cervical cancer.
Screening will not prevent all cases of cervical cancer and some people will still develop cervical cancer even if they go for screening every time they are invited. So, talk to your GP if you are concerned about the symptoms of cervical cancer. Do not wait until your next screening is due.
- Allowing safe exit from cervical cancer screening – which strategy to use is published on HPVWorld.com
- Changes to population screening programmes in Ireland, including CervicalCheck, must first be evaluated by the National Screening Advisory Committee. This independent committee makes recommendations to the Minister for Health and the Department of Health. When recommendations are accepted, we begin planning for implementation.
- We answer your most-asked questions about HPV and cervical cancer.
- Your essential guide to free cervical screening in Ireland.