The HSE’s National Screening Service has today published the CervicalCheck Programme Report 2017-March 2020.
The report covers the period from September 2017 to March 2020, in order to provide a statistical overview of the final years of Ireland’s cytology-based population screening programme. It ends on 30 March 2020, when Ireland moved from cytology-led screening to be one of the first countries in the world to implement a primary HPV screening programme.
Background
In the reported period our national cervical screening programme offered repetitive cytology (smear) testing to the entire population of healthy women* in a specific age group (25–60 years).
The report notes that since the programme began nationally in 2008 it has reduced the incidence of cervical cancer in Ireland by 2.8% per year.
Its findings offer a data-led picture of the screening programme’s operation. It details the programme’s coverage and response times to women – indicating how many eligible women used the service, and how we interacted with them. Metrics concerning the numbers of cell changes and cancers detected through screening and the functioning of the cervical screening system – laboratory, colposcopy, histology – are similarly detailed and measured against key performance indicators, where relevant.
With the inclusion of comparative programme data from 2012-2017, the report also provides reference points with which to view the screening data from this period.
Key facts from CervicalCheck Programme Report September 2017 to March 2020:
- Over 650,000 screening tests taken, with 92% of tests returned as ‘normal’
- Over 33,000 abnormalities detected in women who came for screening
- 293 cancers detected in women who came for screening [see editors’ notes].
Many of the women who had abnormalities detected and treated following screening could have gone on to develop cervical cancer. Many of the women who had cancer detected via screening would not have had cancer found until they developed physical signs or symptoms of disease. Unfortunately, we know that 40% of all cervical cancers are diagnosed in women who have never had a screening test (Cervical screening in cases of cervical cancer in Ireland between 2008 – 2018, RCOG Independent Expert Panel Review). A focus for the programme is working on what barriers these women face in choosing to come for screening, and how we can help address them.
National Screening Service Chief Executive Fiona Murphy said: "Since CervicalCheck began in 2008, more than over 120,000 women have received treatments for cell changes that might have progressed to cancer if left untreated. In addition, 1,700 women have had a cervical cancer detected and treated over the lifetime of the programme. This report details the work done in making these improvements in population health, and the standards met by the programme during this period. As the programme now continues to roll out the new HPV cervical screening test, I am delighted to lead the National Screening Service at this important time for CervicalCheck."
CervicalCheck Clinical Director Dr Nóirín Russell said: "My work as Clinical Director of CervicalCheck began in August 2020, shortly after the implementation of HPV cervical screening. The data contained in this combined report provides a detailed picture of this period in the history of cervical screening in Ireland. It is my aim that the further study of this data – both within our programme and internationally - will aid learning now, and in the future."
CervicalCheck Programme Manager Gráinne Gleeson said: "The data in this annual report is a testament to the work done by our GPs, practice nurses and community screeners, our laboratory partners and colposcopy teams, and all who work in the programme. We are grateful for their diligence, commitment and the impact they have made in improving population health."
Ends.
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Editors’ notes:
- The goal of a cervical screening programme is to reduce the incidence of cervical cancer in an overall population of healthy women. This report shows the incidence of screen-detected cancer is dropping as expected as the programme matures. This is supported by figures from the NCRI which show a significant decline in the total number of women diagnosed with cervical cancer. Notwithstanding the impact of screening on the incidence of cervical cancer in Ireland, over 100 women each year are diagnosed outside of the screening programme when they present with symptoms of cervical cancer. While there are many reasons for this, CervicalCheck is committed to exploring ways to encourage screening uptake in women who do not come for screening. We will continue to emphasise the importance of regular cervical screening as one of the best ways to protect against cervical cancer developing, and give women the opportunity to make an informed choice, considering both the benefits and limitations of cervical screening.
- The cervical screening test is not designed to diagnose cervical cancer. The primary purpose of cervical screening is detection of precancerous changes and prevention of cancers, but it also permits the early detection of a cancer when it is most likely to be treatable and curable.
- At the end of March 2020 CervicalCheck changed to primary HPV testing with follow-up smear (cytology) tests for HPV-positive cases. Both the smear test and the HPV test are simple, safe and affordable tests which are easy to administer and acceptable to women.
- Coverage is the proportion of unique women who have had at least one satisfactory screening test taken within the defined screening interval, expressed as a percentage of the total number of eligible women in the population. The internationally accepted standard for measuring uptake in cervical screening programmes is coverage over five-year periods. Measuring uptake over a five-year screening ‘round’ reduces anomalies that can arise, for example, when a person is invited in a particular year, but attends the following year.
*When the word 'woman' is used in this release it includes women and all people with a cervix.