Cervical cancer screening

The Northern Ireland Cervical Screening Programme aims to reduce the number of women who develop cervical cancer and the number who die from it.

It tries to do this by testing as many women as possible, examining the test results and referring the women for further treatment if any early warning signs are present.

Currently, women aged 25-49 are invited for screening every 3 years and those aged 50-64 are invited every 5 years.

The screening test (often known as a smear test) checks a sample of cells from your cervix for certain types of Human Papillomavirus (HPV). If high-risk HPV (HrHPV) is detected during screening, the sample will also be checked for abnormal cell changes.

These abnormal changes may go on to develop into cancer if left untreated. However, in some cases, particularly young women, the body’s immune system will return the cells to normal by themselves, rendering them harmless.

Women under the age of 25 are not screened because the balance of risks and benefits is different than in older women. Cervical cancer is very rare in this age group, with only one or two cases occurring each year in Northern Ireland. Young women who are screened are more likely to have an abnormal screening test result and undergo further tests and treatments that they do not need. Unnecessary treatment can cause significant anxiety and, in some cases, lead to a higher risk of premature birth in future pregnancies.

Changes to the Northern Ireland Cervical Screening Programme (December 2023)

The Northern Ireland Cervical Screening Programme introduced Primary HPV testing from 11th December 2023. This means samples provided from this date are firstly tested for the presence of High-risk HPV (HrHPV).

Most people will not have HPV. This means your risk of getting cervical cancer is very low. You do not need any further tests to check for abnormal cell changes in your cervix, even if you have had these in the past. You will be invited for screening again in 3 or 5 years.

If you have high risk HPV, your sample will also be checked for abnormal cells under a microscope. If no abnormal cell changes are found you will be invited for another test in 12 months’ time. If you continue to test positive for HPV for the duration of three annual cervical screening test, you will be invited for further tests to check your cervix, even if you have no cell changes (colposcopy).

If you have high risk HPV and abnormal cell changes are found you will be referred to a specialist clinic at the hospital for a test called colposcopy.

Colposcopy is a closer examination of your cervix.

Sometimes there are not enough cells in the sample to get a reliable HPV result. If this happens you will be asked to return for a repeat test in three months’ time.

Further information about HPV can be found here.

The introduction of Primary HPV testing does not change how the sample is taken.

Cervical Screening in the Southern Trust Laboratory
The Southern Health and Social Care Trust provides a Cervical Cytology Service as part of the Northern Ireland Cervical Screening Programme. In July 2022, senior laboratory staff notified the trust’s management team that they had concerns about performance in some steps of their laboratory’s screening system.

To fully investigate these concerns, the trust commissioned the Royal College of Pathologists (RCPath Consulting) to undertake an independent assessment of its cervical screening services from 1 January 2008 and October 2021.

As a precautionary measure, the trust is undertaking a review of the results of some patients who had cervical smears analysed by the trust during this time period.

To find out more information on this issue, visit www.southerntrust.hscni.net.