The National Cervical Screening Programme

What is CervicalCheck - The National Cervical Screening Programme?

CervicalCheck - The National Cervical Screening Programme is a quality assured, organised and population-based screening programme that is managed by the National Cancer Screening Service (NCSS). The programme provides free cervical screening to women aged 25 to 60 and is operated in line with best international practice. The programme is funded by the Department of Health and Children.

Why has a cervical screening programme been introduced?

The overall aim of the programme is to reduce the incidence and the death rate from cervical cancer in Ireland by providing free cervical screening.

Free smear tests are provided every three years for women aged 25 to 44 and every five years for women aged 45 to 60 years. The programme aims to achieve a coverage rate of 80 per cent of the eligible population (women aged 25 to 60). A national screening programme in Ireland has the potential to cut incidence rates from cervical cancer by up to 80 per cent. There are approximately 170 new cases of cervical cancer and 76 deaths from cervical cancer annually in Ireland.

What is the purpose of a smear test?

A smear test (sometimes called a pap test) can detect changes in the cells of the cervix (neck of the womb). The earlier abnormal cell changes are found, the easier they are to treat.

Is cervical screening effective?

Cervical screening is internationally accepted as a preventative health measure. While it is recognised that no screening technology is 100 per cent accurate, cervical screening is the most effective method of reducing a woman’s risk of developing cervical cancer. A screening programme must be well organised and of equal benefit to the entire screening population.

What is the link between CervicalCheck and the ICSP?

The Irish Cervical Screening Programme (ICSP) Phase One commenced screening women in the mid-western area in October 2000. It was originally set up on a pilot basis to provide free cervical screening to women aged between 25 and 60 years in Counties Clare, Limerick and North Tipperary. The ICSP became CervicalCheck in 2008.

Women who participated in the ICSP programme are automatically included in CervicalCheck – The National Cervical Screening Programme. Smeartakers who were previously registered with the ICSP may continue to be registered now in the CervicalCheck programme.

Who is eligible for screening?

Woman aged 25 to 60 resident in Ireland will be eligible to avail of a free smear test over the next three years. CervicalCheck has developed a register (list) of eligible women nationwide aged 25 to 60 through up-to-date information received from the Department of Social and Family Affairs.

Over the next three years, CervicalCheck will send an invitation by post to women on this list who have never had a free CervicalCheck smear test.

Women who have already availed of a CervicalCheck smear test will automatically be re-called when their next smear test is due.

Women are entitled to avail of their free smear test providing:

They attend a smeartaker (a doctor or practice nurse) who is registered with CervicalCheck - The National Cervical Screening Programme
They sign the Cervical Cytology Form
Programme screening intervals are respected (see further detail below)

In addition:
If the result of a woman’s previous smear test recommends further screening, she is eligible for a free smear test
The programme supports any woman who has received a recommendation for a post-colposcopy follow-up smear test
Some additional specific considerations of eligibility apply and a doctor should consult the CervicalCheck Eligibility Framework

Is a woman's written consent necessary to avail of a free smear test as part of the Programme?

Yes. A woman must sign the Cervical Cytology Form to take part in the programme and avail of a free CervicalCheck smear test. This allows CervicalCheck to receive, hold and use a woman's personal details and information about her smear test sample. This may include post-smear samples and colposcopy results. The Cervical Cytology Form has an information sheet attached to it explaining the smear test process and why consent is needed. The information sheet is available to women in Polish, Arabic, Chinese (Mandarin), French, German, Irish, Latvian, Lithuanian, Romanian, Russian and Spanish.

How does the CervicalCheck programme currently work?

To arrange a smear test a woman can contact a registered smeartaker of her choice to make an appointment. Thousands of GPs, practice nurses, Women's Health, Family Planning and Well Woman Clinics all over Ireland are registered and a full list is available in the 'Find a Smeartaker' section of this site. CervicalCheck also sends invitation letters to women who are on the CervicalCheck register. You can check that you are on the register in the 'Check Your Registration/Eligibility' section of this site. If you are not on the register you can add or update your personal details. If you have any questions you can call CervicalCheck on Freephone 1800 45 45 55.

What are the recommended screening intervals?

Women aged 25 to 44 will be offered a free smear test every three years
Women aged 45 to 60 will be offered a free smear test every five years
A woman may also be advised by CervicalCheck to attend for additional smear tests if further investigation is needed, as recommended by the designated cytology laboratory through the programme
The introduction of screening intervals will avoid opportunistic smears (ad hoc or too frequent regular smears) in the longer term

The programme will be based on:

Women attending their registered smeartaker following receipt of a CervicalCheck invitation or re-call letter
Women attending their registered smeartaker for a repeat smear test as advised by a letter from CervicalCheck
Women attending their registered smeartaker without a CervicalCheck invitation or re-call letter but who are eligible for screening in accordance with the Programme's Eligibility Framework

How are smear test results provided to women?

The CervicalCheck programme office writes to a woman with the recommended next step in the screening programme, while smear tests results are issued to her doctor. Results are delivered within four weeks of having a smear test, ensuring a quick service to women. Every test is screened twice by two separate cytologists at a contracted laboratory. The great majority of tests – approximately 90 per cent are negative or normal.

What does CervicalCheck do?

CervicalCheck - The National Cervical Screening Programme is responsible for:

The delivery of a national cervical screening programme
Establishment and management of the register of eligible women – the Cervical Screening Register
Communication with registered women
Co-ordination of registered smeartakers in primary care setting
Co-ordination of laboratory services
Co-ordination of colposcopy and clinic services
Health education and screening promotion
Ensuring quality assurance standards are adhered to across all aspects of the programme

How are an eligible woman's details registered and stored?

The woman’s details are registered and stored confidentially on the Cervical Screening Register (CSR). This is a secure, centrally located, electronic database that contains a woman’s full demographic details including name, address, date of birth and Personal Public Service Number. The CSR also records a woman’s screening history and results of her smear tests, colposcopy procedures and any biopsies taken at a colposcopy clinic.

To maintain confidentiality, each woman has a unique identification number on the register. Information on the CSR will be shared only with the smeartaker, the laboratory, colposcopy clinic and the National Cancer Registry.

Where is the data sourced?

CervicalCheck has developed a Cervical Screening Register (CSR) of eligible women aged 25 to 60 through information received from the Department of Social and Family Affairs, self registration by women, doctors, cytology laboratories and colposcopy clinics. Women are invited for screening based on age, across the age range 25 to 60 years. The CSR has the functionality to identify women in age cohorts based on their date of birth, allowing the Programme to target lower uptake age groups if needed.

What quality assurance measures are in place?

A quality assurance structure is a vital part of the CervicalCheck programme. Quality standards and policies are in place through-out the programme.

The NCSS has established a National Quality Assurance Group that reports to the Director of the NCSS who has responsibility for quality assurance across the National Cancer Screening Service programmes. The National Quality Assurance Group is responsible for the development of quality standards for all aspects of the delivery of a national programme and is supported by a number of specialist subgroups.

Quality assurance sub-groups include:

Primary Care and Smeartaking includes members of the ICGP (Irish College of General Practitioners), practice nurses, NCSS and a nurse tutor
Laboratory, cytology and histology; and
Colposcopy, Gynae-Oncology and primary treatment.

The programme adopted the UK NHSCSP BSCCP / RCOG standards in September 2007. In January 2010 the National Cancer Screening Service published its guidelines for Quality Assurance in Cervical Screening.

Is there a feedback or complaints procedure?

The programme has a feedback and complaints handling system in place that will ensure fair and transparent consideration and investigation. The system is designed so that steps are simple and transparent.

Providing feedback or making a complaint can be done verbally via the Freephone information number (1800 45 45 55) or in writing to the programme office. All communications will be followed up in a timely fashion. CervicalCheck accepts that a good feedback and complaints system contributes to a higher quality service by highlighting shortcomings and capturing positive feedback so that identified areas of the programme can be improved.

CervicalCheck - The National Cervical Screening Programme
PO BOX 161
Limerick

Does CervicalCheck have an access officer?

Yes, CervicalCheck has appointed Fiona Treacy as access officer. She can arrange extra help for people with disabilities who use CervicalCheck's information and services. The Disability Act 2005 requires every public body to have at least one Access Officer. If you need help to use CervicalCheck's information and services you can contact Fiona by phone at (061) 406 500 or (061) 406 551 or by sending an email to access@cervicalcheck.ie.

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