The practice will receive results electronically through HealthLink within 4-6 weeks of the screening test being taken. Results will be issued to the Contracted Doctor or Clinical Lead identified on the screening form. This is why it is extremely important that the details of the contracted doctor / clinic are correctly entered in section C of the Cervical Screening Form to ensure that the result is delivered to the correct doctor / clinic.
Yes, the woman will receive a personal notification of their cervical screening test result by letter from CervicalCheck. The woman’s results letter will tell her if she had HPV detected or not. If HPV has been detected and a reflex cytology test applied, then the woman will be told if her sample had abnormal cells detected or not. She will not be given the grade of cell change found in her sample; this level of detailed information is only forwarded to the practice of the Contracted Doctor. The woman will also receive an information leaflet with an overview of results. Results are issued to the practice / clinic by the laboratory and result letters are issued to women by CervicalCheck.
The following are samples of screening results letters that a person could receive:
When the result is a HPV not found the result letter tells the woman when her next screening test is due. If a repeat test or a referral to colposcopy is required, the letter advises the woman to contact their doctor/nurse who took the test to discuss the result and what the next steps are.
Every woman who receives a result will also receive an information leaflet ‘Important information about your HPV cervical screening results’.
If a woman requires referral to colposcopy, she will also receive an information leaflet ‘Important Information about Your Colposcopy’
The sample taker is responsible to ensure that the woman gets her result. The practice/clinic should have a results management protocol such as that designed by CervicalCheck CervicalCheck Delivering a cervical screening service Protocol which should include clear directions on roles and responsibilities for obtaining results of screening tests and providing women with their results. All staff including administration staff should be aware and informed of the protocol.
The sample taker should inform the woman at time of initial appointment of how and when she should receive her result.
- On the day of the test, the sample taker must check that the address on the cervical screening form is correct and up to date with the women. The address on the form is the address used to update the Cervical Screening Register (when incoming address is different) and the address to which the result letter and future call letters are sent.
- Each practice should have a results management protocol for the provision and communication of screening test results. CervicalCheck Delivering a Cervical screening service Protocol
- The practice results management protocol must include the identification of overdue results (e.g. results outstanding after four weeks) and include steps on appropriate follow-up with the laboratory. A result must be received for each cervical screening sample dispatched to the programme laboratory, and every result must be cross checked against the original sample on the practice management system.
- The sample taker must check that the management recommendation assigned to the result by the laboratory is correct in relation to the woman’s CervicalCheck screening history. Sample takers must contact the laboratory if they have queries in relation to results or management recommendations.
- Cervical screening test results must be recorded in the correct woman’s medical record. The woman’s medical record must be updated with the cervical screening test result and management recommendation. Be cautious with electronic results to ensure that they have been downloaded into the correct patient’s file, especially in cases where there is more than one patient on your IT system with similar / same first and last names
- It is the responsibility of the sample taker to contact the woman regarding her screening test result. If the result is abnormal, the woman must be given full details of the result and advised of the next step in the process of their management. Explanations should be clear and appropriate to the level of understanding of each individual patient.
- The sample taker must ensure that reasonable efforts are made to follow-up screening test management recommendations. Appropriate action includes two recorded attempts to contact the woman, one of which is in writing. If the management recommendation is onward referral the sample taker must ensure that this is done.
Sample takers must access the most current information and documentation in relation to screening test results and management recommendations. Click here to download the most up to date Cervical screening results and recommendation table.
Yes, if the woman requires a face-to-face consultation to discuss results this should be facilitated at no additional cost to the woman. The woman should not be asked to pay a fee for this consultation. It is included in the fee paid to the contract holder for the initial cervical screening test consultation.
If abnormal bleeding, such as post coital bleeding or post-menopausal bleeding is indicated on the Cervical Screening Form, the lab will recommend that you "Refer to Specialist Gynaecology for opinion". This is to prompt you to refer a symptomatic woman for clinical assessment to gynaecology service.
In women over the age of 45, the laboratory must report when endometrial cells are present (Bethesda reporting). There is a very small chance that the presence of endometrial cells may indicate endometrial pathology. In these cases, the lab will recommend on the report "Refer to Specialist Gynaecology for opinion. The presence of endometrial cells should be interpreted clinically based on the woman’s menstrual history and examination."
The cervical screening test result may also report incidental findings such as infections e.g. actinomyces, candida albicans. A clinical assessment of the symptoms may be helpful prior to advising treatment.
The most common reasons for not processing a sample and requiring a repeat test no earlier than 3 calendar months from the date of the previous test are:
- The vial has expired (manufacturer’s label on vial).
- The sample has expired (received in laboratory 6 weeks after sample taken).
- Screening test repeated too soon (must be 3 calendar months since last test).
- Consent has not been given on the form
- Sample heavily bloodstained
- Entire cervix not visualised (if cervix is present).
Less common reasons
- Blank vial
- Information on form does not match information on vial
- Peel off label remains on the vial (has not been affixed to form) & vial is blank
- The sample has leaked.
- There is too much fluid in the vial
- Sample site is not identified
- Demographic mix-up (details of more than one woman on the form)
- Case of mistaken identity (all details on the form belong to another women – usually
A HPV result may be indeterminate – laboratory unable to obtain a valid result.
The reflex cytology result following a detected HPV test may be cytology unsatisfactory due to:
- Scant cellularity (most commonly seen in post-menopausal women).
- Cervix swabbed prior to test being taken (if required, swabs should be taken after screening).
- Presence of foreign material (e.g. lubricant).
- Obscuring inflammation.
- Excessive cytolysis or autolysis (broken cells usually caused by bacteria or excessive force used on broom when rinsing).
The recommended follow-up for women who are living with HIV, on renal dialysis, or pre/post-transplant is annual screening from diagnosis and referral to colposcopy following one HPV positive result regardless of cytology result. Women about to undergo organ transplant should have a screening test performed within a year of the transplant. Click here to download the most up to date
HPV Primary Screening Eligibility Framework
The programme sends a Hysterectomy data collection form when a HPV negative vault sample has been processed by the programme laboratory. This means that the vault was ticked on the cervical screening form.
The Hysterectomy data collection form should be signed by the Clinically Responsible Doctor/treating clinician and returned to the programme only where no further vault screening is required. By signing the form, the signatory confirms that the woman has had a total hysterectomy and does not require future screening in line with the criteria described in the hysterectomy section of the Eligibility Framework. CervicalCheck have developed a clinical guidance note Cervical screening post hysterectomy which can be found on the CervicalCheck website. Once the form is received and processed by CervicalCheck, the status of the woman’s record on the Cervical Screening Register is set to inactive which means that CervicalCheck ceases to send her screening invitations. It may be necessary for doctors /clinics to contact treating gynaecologists in relation to the histology / future screening requirements for the patient.
When the programme laboratory recommends referral to colposcopy, CervicalCheck sends a partly pre-filled Colposcopy Referral Form by post to doctors and clinics. The pre-filled form should be used, rather than using handwritten or practice developed forms. The referral must be accompanied by a copy of the screening test result, to ensure that it is processed in a timely manner. A colposcopy referral needs to be sent within 10 working days of receipt of the result recommendation (you may have to wait a day or two to receive the partially completed referral form from CervicalCheck).
CervicalCheck are currently rolling out electronic referrals to colposcopy, so depending on your primary allocated colposcopy clinic and secondary allocated colposcopy clinic, you may be able to refer electronically to some colposcopy clinics via your practice management system. CervicalCheck will notify you when this facility is available in your area.
Doctors / clinics must inform women about what is involved when attending colposcopy. Women will receive a colposcopy information booklet with their result letter from the programme but a face-to-face consultation should be offered when required. The woman may choose to attend any of the 15 CervicalCheck colposcopy clinics nationwide.
The failsafe process in CervicalCheck is used when a woman with an abnormal result or a discharge recommendation from colposcopy does not attend for her next recommended action as part of the CervicalCheck programme. As the clinically responsible doctor for resulted tests where follow-up recommendations have not been followed in a timely manner, you receive failsafe letters (also known as abnormal follow-up letters) requesting information about the service user. The information that you provide is used to update the service user’s record on the Cervical Screening Register to ensure that CervicalCheck maintains contact with her for her follow-up.
The Primary Care chapter of the Standards for QA in Cervical Screening in Primary Care & Other Settings requires two recorded attempts to contact the service user in relation to her follow-up. This means you must record them on either the hardcopy or online failsafe and include the types (phone, email, etc…) and date(s) of contact. If you have information that the service user has emigrated, has changed address, has decided to attend private colposcopy or attend for a private cervical screening test, these should be added to the failsafe response. Once you have submitted the failsafe response to CervicalCheck, your obligation for follow-up has been completed.
You can respond to failsafe online here.