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Published: 10 May 2024

New research shows differences in response rates to cervical screening by invitation type

by Micheál Rourke, Data Analyst, National Screening Service

We’ve completed a review of how women respond to different invitation types to attend for cervical screening.

Our CervicalCheck programme moved to primary HPV cervical screening in 2020 and at the same time we changed the screening age range from 25-60 to 25-65. The move to HPV testing involved changes to intervals between screening as follows:

  • the 3-year recall changed from women aged 25 to 44 to women aged 25 to 29
  • the 5-year recall changed from women aged 45 to 60 to women aged 30 to 65
  • a 1-year recall was introduced for women who have HPV but have no abnormal cells

Women get an invitation letter from CervicalCheck asking them to book an appointment with their GP or general practice nurse for their HPV cervical screening test.

Invitation types

There are 6 different invitation paths for cervical screening:

  • New invites: an invitation to women to attend for their first HPV cervical screening test
  • 1-year recall: an invitation sent to women 10 to 12 months after their last screening when they have a ‘HPV found’ result without abnormal cells
  • 3-year invite: an invitation to women aged 25 to 29 who have:

- a previous recorded normal screening test result

- not responded to a previous invite, or

- a clinical history that indicates a repeat screening in 3 years

  • 5-year invite: an invitation to women aged 30 to 65 who have:

- a previous recorded normal screening test result

- not responded to a previous invite, or

- a clinical history that indicates a repeat screening in 5 years

  • Lapsed attender invite: an invitation sent to women 35 months after their last invitation letter if they have not yet attended
  • Non-responder invite: an invitation sent to women who have been invited to attend for a screening test but have never attended

What we did

We analysed data for the period 1 April 2020 to 31 March 2022 to see at what point in time, if any, women attended for their cervical screening test after receiving their invitation letter, up to two years after it was sent.

What we found

There are some large differences between invitation types and the response rates.

  • The data shows that women who plan to attend for cervical screening will have usually done so within 9 to 12 months after receiving their invitation, regardless of invitation type. The response rate after 12 months is low for all invitation types.
  • 60% of new invitees, 3-year, 5-year and 1-year repeat invitees, will attend for screening within 6 months. This increased to between 75% and 90% within 12 months.
  • Lapsed attenders and non-responders had the lowest response rates with only 20% of lapsed attenders and 5% of non-responders attending for a screening test within 12 months of receiving an invitation.

What this tells us

This research gives us a better understanding of cervical screening behaviours and how women respond to different types of invitations. This will help us to improve how we predict screening attendance rates. These projections are important in planning future programme activity including laboratory testing and colposcopy clinic activity.