Reviewing your cervical screening history

We know that this is a difficult time for you and naturally you will be concerned about your treatment and future health. However, you may also be wondering why you have developed cervical cancer, especially if you have had screening tests (often known as smear tests) in the past.

Cervical screening reduces the risk of developing cervical cancer. Regular screening is the best way to detect changes to the cervix early on, but like other screening tests it isn’t perfect.

The cervical screening process involves many different steps which aim to identify and treat abnormal cells on the cervix to prevent cervical cancer. It may be that all the steps have been followed efficiently and that a cervical cancer has developed despite the thorough screening programme. Or it could be that at one or more of these steps the test may not have worked as well as it should. Reviewing your previous tests will help identify if anything should have been done differently.

Reviews are an essential part of every screening programme. Information we gather from individual cases helps us to learn more about how cancers develop and how they are diagnosed.

What does the review involve?

We review your screening history to ensure that the invitations to attend cervical screening were sent at the appropriate time and that your screening history meets national guide lines.

Where appropriate your GP is contacted to review your medical notes.

What will the review show?

In most cases the review will show that the correct procedures have been followed and that you received appropriate care. Occasionally the review may find that one or more steps in the process have not worked as well as they should. This may highlight where we could make improvements.

Could my cancer have been found earlier?

In many cases the cancer will have been detected at the earliest possible stage. Although cervical screening prevents a high percentage of cervical cancers (about 75%) it cannot prevent all of them. The review process aims to highlight any possible areas of weakness so we can make improvements for everyone. Some examples are given below.

Screening cannot always identify abnormal cells on a cervical sample slide because:

• sometimes the cells do not look much different from normal cells
• there may be very few abnormal cells on the slide
• the person reading the slide may miss the abnormality (this happens occasionally, no matter how experienced the reader is)

Colposcopy (a visual examination of the cervix) cannot always identify abnormal areas of the cervix because:

• the abnormal area might not be visible during the examination
• the abnormal area might not be taken as a sample in a biopsy
• the abnormal cells might be hidden higher up inside the cervix
• some types of abnormality are simply not easy to identify at colposcopy

What happens to the information collected for my review?

We collect screening information as part of an ongoing process. Your information (without your name) goes towards improving the systems of the programme and helps researchers to discover more about how cancers develop and how they are diagnosed and treated.

What happens next?

We will send you a letter confirming that the review has commenced. The review itself can sometimes take a few months to be completed. Once the review has been completed we will send you a letter to let you know that the review findings are available should you wish to have them. We can arrange an appointment to discuss those findings, should you wish.

Can my family ask for the results if I don't want to know?

No, unless you give permission, we cannot give your relatives access to any details of your medical records.

Why should women bother to go for cervical screening if abnormalities can be missed?

Cervical screening reduces the risk of developing cervical cancer. The cervical screening programme is estimated to save 4500 lives a year nationally, and regular screening is the best way to detect early changes to the cervix.

Please contact your key worker if you:

• have any questions or
• haven’t heard about the results of the review