Cervical Screening

Revised Colposcopy and Programme Management Applicable from 01 October 2011

The second version of the NHS Cervical Screening Programme (NHSCSP) Publication 20, Colposcopy and Programme Management, has been reviewed and an addendum has been developed describing exceptions to the publication that are applicable to the Scottish Cervical Screening Programme. This addendum should therefore be used in conjunction with and as a supplement to NHSCSP Publication 20, Second Edition, May 2010. Please click here to find the addendum, which includes a link to the NHSCSP Publication.

Cervical screening has proven to be an effective method of reducing the incidence and mortality of cervical cancer. Screening provides a test that involves checking cells in the cervix (neck of the womb) and a Human Papilloma Virus (HPV) test, where appropriate. The test is designed to pick up any changes so that they can be simply and effectively monitored or treated. Cervical screening saves around 5,000 lives in the UK every year and prevents 8 out of 10 cervical cancers from developing. Cervical screening is routinely offered every three years to women aged between 20 and 60 years of age.

More information on the cervical screening programme and the link between cervical cancer and the Human Papilloma Virus (HPV) is available on the external NHS Health Scotland website:

http://www.healthscotland.com/topics/health-topics/screening/cervical.aspx.

A suite of information leaflets is also available on the external NHS Health Scotland website in a number of translations and alternative formats:

http://www.healthscotland.com/documents/223.aspx.

The implementation of the Scottish Cervical Call Recall System (SCCRS) took place on 29th May 2007. It replaced all legacy systems for cervical screening call recall, including those used in general practice. The SCCRS application, accessible by over 12,000 users over the secure NHS network, offers a single Scotland-wide database to support the Scottish Cervical Screening Programme. It is used by a wide range of NHS staff including General Practitioners, Nurses, Family Planning Consultants, Colposcopists. Gynaecologists, Laboratory scientists, Cytopathologists, Consultants in Public Health medicine and Call / Recall Office staff. SCCRS has introduced electronic smear test requesting and results reporting. Significant benefits are the instant availability of clinical information at the point of patient care and notification of smear test results to women. The SCCRS application and User Sections are available to NHS professionals over a secure NHSnet connection.

Test of Cure Early Implementation Study

The Test of Cure early Implementation Study commenced 1 February 2011 in Scottish Pilot Sites: NHS Grampian, Orkney, Shetland, Highland, Western Isles and Lothian.

Following current Scottish protocol, women treated for CIN 2 and 3 in all other NHS Board areas have a cervical 'smear test' (cytology alone) every year, for five years following their treatment, before they can be considered for return to routine screening.

From the 1st February, women in the pilot sites who have been treated for CIN 2 and 3 since 1st August 2010 will have their sample tested for HPV (Human Papilloma Virus) in addition to cytology at 6 and 12 months and a cytology test alone at 24 months.

The HPV test is important because it is now known that women who are HPV negative at 6 months and 12 months following treatment, and who also have no cytological changes at 6, 12 and 24 months after treatment can be returned to routine screening. This means women can return to routine screening three years earlier than at present.

HPV Testing

With the exception of the Test of Cure early implementation study, HPV testing is not currently undertaken as part of the cervical screening programme in Scotland. Women moving into Scotland will be followed up/managed in accordance with the current Scottish screening policy irrespective of HPV test results taken elsewhere.

Cervical Cytology EQA Scheme

The NHS Scotland Cervical Cytology EQA Scheme is a specialist service funded by NSD. The scheme has three components:

Interpretive Assessment
Educational Slide Circulation
Technical Assessment

The aims of the EQA Scheme are:

To contribute towards the establishment and upholding of minimum national standards in the cervical screening programme.
To promote consistence in reporting across the country.
To facilitate continuing education and professional development within laboratories by providing regular access to interesting and relevant cytological material.
To enhance the experience and confidence of cervical cytopathology staff in their reporting practice.
To contribute to improving the quality of technical procedures undertaken by laboratories.
To assist in meeting accreditation standards relating to EQA.

Annual Report

The most recent annual report for the Cervical Cytology EQA scheme is available below:

Cervical Cytology EQA Scheme annual report 2009/10 [13 pages, 251Kb]

Cervical Cytology Training School

The Scottish Cytology Training School is a specialist service with relevant elements funded by NSD.

NHS Lothian provides a variety of training and continuing professional development courses ranging from Introductory to Advanced Practitioner Courses for relevant laboratory staff involved in the Scottish Cervical Screening Programme. These courses also accommodate screening staff from out with NHS Scotland and are run from two centres, Edinburgh Royal Infirmary and Glasgow Royal Infirmary. The Training School has again achieved full approval status as a cytology training centre.

Annual Report

The most recent annual report for the Cervical Cytology Training School is available below:

Cervical Cytology Training School annual report 2009/10 [6 pages, 313Kb]

National Services Division contacts:

To contact members of NSD staff, please visit our staff contacts page.

Isabel Gavin, Programme Manager
Tracey Curtis, Assistant Programme Manager
Carol Woods, Programme Support Officer