- How does CervicalCheck invite women to be part of the programme?
- When will a woman be called back after her first CervicalCheck smear test?
- Informed consent of women
- Is there evidence regarding the benefits of screening for woman aged under 25 years?
- Why has the processing of opportunistic smeartaking stopped?
How does CervicalCheck invite women to be part of the programme?
CervicalCheck operates an organised call, re-call system of invitation, in line with best international practice. This ensures an effective and efficient population approach to screening that maximises target population coverage.
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 Protection, from self-registration and colposcopy details. Every woman on the register has been allocated a CSP ID. Over each three year screening round, CervicalCheck will send an invitation letter by post to eligible women on this list who have never had a CervicalCheck smear test inviting them for their free smear test.
In addition to call and re-call letters of invitation, direct programme entry by smeartakers of eligible women who have not yet had a CervicalCheck smear test has been introduced. Smeartakers can facilitate a smear test for these new eligible women without the woman having a letter of invitation during the normal course of a consultation or by recruiting the woman directly. A woman's eligibility can be checked online under the 'Check Woman's Eligibility' tab in this section.
Eligible women must be normally resident and have a postal address in the Republic of Ireland.
A woman must sign the Cervical Cytology Form to take part in the programme and avail of a free CervicalCheck smear test. 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 in Polish, Arabic, Chinese (Mandarin), French, German, Irish, Latvian, Lithuanian, Romanian, Russian and Spanish. All translated information sheets are available to view and download in the 'Useful forms and downloads' section of this site.
- The smeartaker should check a woman's date of birth (DOB) before taking the smear test to ensure the sample is for the correct woman
- Smeartakers are responsible for giving women their results
- Smeartakers are responsible for making referrals as advised by the laboratory
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When will a woman be called back after her first CervicalCheck smear test?
Women who join the Programme, regardless of age, will need to have two negative smear test results; three years apart before they move onto a five yearly re-call. Women aged 25 to 44 will be invited for a free smear test every three years and following two consecutive no abnormality detected smear test results women aged 45 to 60 will be invited every five years.
If a woman or her smeartaker is unsure about eligibility for a CervicalCheck smear test, they can check online under the 'Check Woman's Eligibility' tab on the left hand side of this page or contact CervicalCheck on Freephone 1800 45 45 55 for advice.
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Informed consent of women
A woman's consent, by signature or by witnessed mark, is required to participate in CervicalCheck. Only the woman herself may provide consent. Consent to participate can never be given by a third party.
The Information Sheet for Women (cover sheet of the Cervical Cytology form) should be provided to every woman who attends for a smear test. It explains to a woman what her consent means within the cervical screening programme.
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Is there evidence regarding the benefits of screening for woman aged under 25 years?
International best practice recommends that a population based cervical screening programme should target women aged from 25 or 30 years to 60 or 65 years.
Based on evidence to date, there is no additional public health benefit in starting screening below the age of 25.
In women under the age of 25, minor changes in the cells of the cervix are common but invasive cancer is extremely rare. Population based screening in women under the age of 25 may lead to many women receiving unnecessary treatment for lesions that would never have developed into invasive cancer.
Once screening begins at the age of 25, lesions that are likely to progress will be screen-detectable. Lesions that regress will no longer be a source of concern.
Any woman under the age of 25 who is concerned about her risk of developing cervical cancer or her sexual health should contact her doctor or Genito-Urinary Medicine (GUM) clinic.
There is no firm evidence that indicates the optimal age to cease screening but in most international programmes it is 60 or 65. The natural history and progression of cervical cancer means that it is highly unlikely that such women will go on to develop the disease. Women aged 60 and over who have never had a smear test are entitled to have two under the National Cervical Screening Programme.
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Why has the processing of opportunistic smeartaking stopped?
Screening is for asymptomatic women.
A smear test is a screening test - not a diagnostic test.
Opportunistic smeartaking is not effective and does not impact on levels of detection of cervical cancer.
Consistent with best international practice, opportunistic screening outside programme screening intervals (e.g. routine screening of pregnant or post-natal women, routine screening of women using contraception, HRT or routine screening of women undergoing investigation for genital infection or for those previously used to excessively frequent screening) is considered inappropriate. Consistent with international best practice, opportunistic screening is discouraged.
If a woman presents to a smeartaker with symptoms suggestive of gynaecological cancer the woman should be referred directly for urgent gynaecological review.
Opportunistic smeartaking is prevalent in post natal follow-up care. This is not the ideal time for effective smear test taking and should be discouraged to correct the inappropriate link between pregnancy and smear tests.
If a woman presents with symptoms suggestive of a sexually transmitted infection e.g. genital warts, she should not be given a smear test but rather referred for a full STI assessment in a GUM clinic. Such presentations are not a symptom of cervical cancer and accordingly a smear test is considered inappropriate and unnecessary and should be discouraged.
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