About the programme

1. Overview of CervicalCheck
2. Rationale for screening women aged 25 to 60
3. Cessation of opportunistic smeartaking
4. CervicalCheck Eligibility Framework
5. Smeartaker co-ordination and smeartaker training

Overview of CervicalCheck

• The National Cancer Screening Service (NCSS)  launched CervicalCheck - The National Cervical Screening Programme in September 2008
• CervicalCheck is a national, population-based, quality assured cervical screening programme
• Screening is recommended every three years for women aged 25 to 44 and every five years for women aged 45 to 60, in line with best international practice
• CervicalCheck has developed a secure register (list) of eligible woman aged 25 to 60 nationwide through up-to-date information sourced from the Department of Social Protection and self registration of women 
• Results are provided to women by the programme office within four weeks of having their smear test taken and every test is screened twice by two separate cytologists
• The successful introduction of an organised, well-managed, national cervical screening programme has the potential to reduce current incidence rates from cervical cancer among women in Ireland by up to 80%. There are approximately 76 deaths from cervical cancer annually in Ireland
• Quality assured colposcopy services are available for women who may require follow-up treatment
• On 1 September 2010 CervicalCheck entered its third year of operation and final year of its first three year screening round. To coincide, the programme moved to the third phase of encouraging participation among women with the introduction of direct programme entry (by smeartakers) of new eligible women. This will be in addition to our ongoing call, re-call letters of invitation
• A woman's eligibility for a CervicalCheck smear test can be checked online under the 'Check Woman's Eligibility' tab on the left hand side of this page

Rationale for screening women aged 25 to 60

• 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.
• Effectiveness of cervical screening with age: population based case- control study of prospectively recorded data - Article from the Brittish Medical Journal first published in August 2009

Cessation of opportunistic smeartaking/clinically indicated smear test

• 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.

CervicalCheck Eligibility Framework

• CervicalCheck has developed a framework for smeartakers which provides clinical guidance on eligibility criteria and referral pathways. Please click on the link below to download a copy of the framework.
• CervicalCheck eligibility framework

Smeartaker co-ordination and smeartaker training

• The Smeartaker Co-ordinator can address any queries smeartakers may have and can be contacted by emailing stcoordinator@cervicalcheck.ie or by telephone: 061 406500.
• Queries regarding smeartaker training and resources can be directed to the Smeartaker Training Unit by emailing stu@cervicalcheck.ie or by telephone: 061 406564.