Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what representations he has received about increasing access to cervical screenings for women under the age of 25.

A parliamentary debate on cervical screening was held on 1 May 2014, Official Report, column 1025. The debate was secured by the Member for Liverpool, Walton (Steve Rotheram) and the focus of the debate was cervical cancer and screening in younger women.

A search of the Department’s Ministerial correspondence database has identified 11 items of correspondence received since 1 January 2015 about cervical screening for women under the age of 25. This is a minimum figure which represents correspondence received by the Department’s Ministerial correspondence unit only.

In 2012 the UK National Screening Committee recommended that the age of first invitation for cervical screening should be age 25 on the basis that there is evidence of a large number of women screened and treated with relatively little benefit below this age. Cervical cancer in women under the age of 25 is very rare with just 2.6 cases per 100,000 women. Younger women often undergo natural and harmless changes in the cervix that screening would identify as cervical abnormalities, and in most cases these abnormalities resolve themselves without any need for treatment.

Guidance for primary care on the management of young women who present with gynecological symptoms was developed and published in March 2010, Clinical practice guidelines for the assessment of young women aged 20-24 with abnormal vaginal bleeding. The guidance was produced by a multi-disciplinary group, including professionals, patients and the voluntary sector. It was reviewed by a number of general practitioners (GPs), and was endorsed by the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners and the Royal College of Physicians.

A smear test is primarily used for screening purposes, and is unlikely to be appropriate when a woman has gynaecological issues that are symptomatic of cancer. In such cases the National Institute for Health and Care Excellence Referral Guidelines for Suspected Cancer (2005) are available to help GPs assess when it is appropriate to refer patients for suspected cancer, including cervical cancer. The Guidelines make clear recommendations in relation to gynaecological cancer, and state that:

“A patient who presents with symptoms suggesting gynaecological cancer should be referred to a team specialising in the management of gynaecological cancer, depending on local arrangements.”

In relation to cervical cancer the Guidelines make clear that a smear test is not required before referral:

“In patients found on examination to have clinical features that raise the suspicion of cervical cancer, an urgent referral should be made. A cervical smear test is not required before referral, and a previous negative cancer smear result is not a reason to delay referral.”

Therefore, when a woman is experiencing gynaecological problems which are symptomatic of gynaecological cancer, their GP would be expected to refer them to the appropriate specialist without needing to conduct a smear test.