adult screening programme

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Cervical cancer

The cervix is the lower part (or neck) of the womb, made of muscle tissue. It is the entrance to the womb from the vagina. Cancer of the cervix is a relatively rare type of cancer. In the UK, approximately 2,800 women are diagnosed with it each year.

Read more about cervical cancer on the NHS website.

UK NSC screening recommendation Based on the last UK NSC review of this condition that occurred in February 2019.

Screening for this condition is recommended.

Cervical screening started in England in 1964. This means the UK NSC has not formally considered the evidence for cervical screening, though it has made several recommendations to improve cervical screening (which is estimated to save 4,500 lives in the UK each year).

The UK NSC reviewed the starting age for cervical screening in 2013 and recommended it should be increased from 20 to 25. This is because the committee found that cervical screening in women under 25 would do more harm than good because:

  • cervical cancer is extremely rare in women under 25, despite cervical abnormalities being quite common
  • a study found that for every 100,000 women invited for screening from the age of 20, the number of cervical cancers would not be reduced but an extra 8,000 women would need further investigation and 3,000 more would have unnecessary treatment
  • repeated treatments for cervical abnormalities can increase the chance of premature births if a women goes on to become pregnant

In 2015, the UK NSC recommended changing the primary screening test from cytology (looking at cervical cells through a microscope to find those which could develop into cancer) to testing for high-risk human papillomavirus (HPV). This is because:

  • over 99% of cervical cancers are caused by HPV
  • vaccinating children aged 12 and 13 for HPV strengthens the case for using HPV as the primary screening test
  • it will save more lives by determining a woman’s risk of cancer earlier, which means the screening interval can be extended to 5 years
  • if a woman is found not to have high risk HPV, her chances of developing cancer within 5 years are very small

In February 2019, the UK NSC recommended a modification to the NHS Cervical Screening Programme, to stratify screening by risk by:

  • extending screening intervals from 3 to 5 years for women aged 25 to 49 who test HPV negative as part of their routine screen.

  • implementing 12-month surveillance for women who are HPV positive and cytology negative

  • implementing a 12-month recall for women who are HPV positive/cytology negative at their final screen aged 64. Women who are still HPV positive at this follow-up appointment should be referred to colposcopy

In November 2023, the UK NSC endorsed the use of digital pathology as an alternative option to light microscopy for the review of cervical screening histopathology slides. This followed a consultation into the results of Health Technology Assessment study that found that digital pathology performs as well as light microscopy in cancer screening.

Supporting documents from the 2019 review

Cervical 2018 combined
This document provides the evidence on which the current UK NSC recommendation is based.

UK NSC coversheet & consultation responses cervical cancer (2019)
This document summarises the review process including the public consultation comments.

Screening around the UK

The UK NSC recommends screening for this condition, however this may vary slightly depending on where you are in the UK.

Find out more about screening programmes across the UK.

Review cycle

Date previous review completed: 2019

Next review estimated to be completed: 2024 to 2025.

To see previous evidence reviews, visit the UK NSC archive.

Organisations interested in Cervical cancer

These organisations have expressed interest in this recommendation and may submit responses to evidence reviews.

List of organisations

If you think your organisation should be added, please contact us.