Information for health professionals
Bulletin Board
Call, Re-call Approach to Cervical Screening
In September, CervicalCheck moved to an organised call, re-call system of invitation, in line with best international practice and to ensure that an effective and efficient population approach to screening that maximises target population coverage is maintained.
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 letter by post to eligible women on this list who have never had a CervicalCheck smear test for their free smear test.
Any woman that has not had a smear test in the last three years can opt-in and request an invitation letter from CervicalCheck by registering online at www.cervicalcheck.ie, completing and returning a Freepost Form, or by calling CervicalCheck on Freephone 1800 45 45 55.
What women do not require a CervicalCheck letter do not need to contact the programme office and do not need to register online?
- Women who have had a CervicalCheck smear result requiring repeat
- Women over 60 who have never had a smear test
- Women of any age post colposcopy
- Women post hysterectomy in certain circumstances
- Women aged 20 and over on renal dialysis
- Women aged 20 and over with HIV infection
- Women aged 20 and over post organ transplant
If women have participated in CervicalCheck and have received a normal result requiring an early repeat due to history yet does not have the result to hand, the Smeartaker should call the programme office to check eligibility.
In the above situations please ensure history is documented clearly on the cytology form.
What women require invitation letters?
- Women who are new to the CervicalCheck Programme
These women will receive a letter inviting them for a smear test. Contacting the programme office for a CSP ID number will not make these women eligible.
From 1 September 2009 any smear test taken outside the criteria outlined above will not be considered eligible and accordingly will not be processed by CervicalCheck.
What about women who had a CervicalCheck smear test already?
Women who have already availed of a CervicalCheck smear test since 1 September 2008 will automatically be re-called when their next smear test is due.
Smeartakers should also be aware of the following:
- Can the smeartaker please check a woman's date of birth (DOB) before taking the smear test to enusre the sample is for the correct woman
- Smeartakers are responsible for giving women results
- Smeartakers are responsible for making referrals as advised by the laboratory
Is there evidence regarding the benefits of screening for woman aged under 25 years?
See the latest evidence under section Evidence papers and further reading – Effectiveness of cervical screening with age. This summarises the work done for the UK Advisory Committee on Cervical Screening and is the most up to date evidence base as to why the population programme does not screen below the age of 25.
When will the patient be called back after her first CervicalCheck smear?
Women over 60 require two negative smear tests three years apart before discharge from
CervicalCheck.
What do we do if a woman has had a hysterectomy?
For women on routine re-call for at least 10 years prior to hysterectomy and no CIN in the sample at hysterectomy, no vault cytology is required.
For women with less than 10 years routine re-call and no CIN at hysterectomy, a sample should be taken from the vault six months after surgery and there should be no further cytology follow-up if it is negative (NAD).
For women with completely excised CIN at hysterectomy, a sample should be taken from the vault at six, 12 and 18 months after surgery and there should be no further cytology follow-up if all are negative (NAD).
For women with incomplete or uncertain excision of CIN, follow-up should be conducted as if the cervix were still in situ.
Whose responsibility is it to return failsafe to CervicalCheck?
The return of failsafe is the smeartakers responsibility; and not the colposcopy clinic.
Why did another GP in my practice get paid for smear tests I have taken?
The IMC/GMS number for a different GP may have been documented on the cytology form in error. Therefore when completing the cytology forms please ensure your own IMC/GMS numbers are used. (the clinically responsible doctor and payee numbers must be for the same GP).
When referring to colposcopy, the GP must:
- Use Colposcopy Referral Form
- Include smear report with referral
- Differentiate between AGC/AGH & ASC-US (Glandular BNA & Squamous BNA)
My patient is HIV positive and needs annual cytology, what do I do?
Advisory Notes
Ensuring the correct Management Recommendation:
On the Cervical Cytology Form smeartakers should ensure that the previous smear and previous treatment sections are completed appropriately and completely for each sample.
Early repeats/ inappropriate smear tests:
Best clinical practice in cervical screening recommends that a woman should not have a repeat smear test before three months have elapsed.
Smeartakers should ensure that a woman’s previous smear was dated at least three months earlier before proceeding to take another smear.
Smear tests taken for the same woman before 12 weeks have elapsed are deemed ineligible and will not be paid for by the programme, and samples may be returned rather than processed by the Programme cytology laboratory.
Women that are recommended to have a repeat smear test within six months (R4 Management Recommendation) should not have a Programme smear test before five months have elapsed.
Women that are recommended to have a repeat smear test within twelve months following a negative result (NAD) (R3 Management Recommendation) should not have a Programme smear test before 10 months have elapsed.
The eligibility of a woman for a free programme smear test is determined by the management recommendation accompanying her previous smear result. Smear tests taken for the same woman before the recommended times above have elapsed will be deemed ineligible and will not be paid for by the Programme, and samples may be returned rather than processed by the Programme cytology laboratory
Where a woman or her smeartaker are unsure about her eligibility for a Programme smear test, the CervicalCheck Freephone Line (1800 45 45 55) should be contacted for advice.
