Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, pursuant to the Answer of 3 March 2015 to Question 225373, if he will make it his policy that GPs should be able to commission cervical smear tests for diagnostic purposes to investigate presenting symptoms outside the routine screening timeframes; and what additional opportunities there are for patients to be tested for diagnostic purposes outside the screening programme.

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 general practitioners (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.