Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the effect of increasing cervical screening rates on (a) prevention and (b) early diagnosis of cervical cancer.

A leaflet sent out with every invitation for cervical screening provides women with clear, honest and balanced information about the benefits and limitations of cervical screening in order to ensure women are able to make an informed decision as to whether to have a cervical screening test or not.

Improving Outcomes: A Strategy for Cancer (January 2011) makes clear the important role that cervical screening plays in preventing cervical cancer. The strategy also notes that some groups and communities are not accessing cancer screening services. Public Health England (PHE) is working with NHS England via the Public Health Section 7A agreement to develop a system of performance improvement through the use of performance floors, and strengthened governance for screening. The aims of the performance floors are:

- Improving performance and equity of service over time by reducing the range of variation at a local level.

- Enabling easy identification of poor performance and the setting of objectives and plans for local action, to reduce variation and improve performance.

PHE will look at research provided by the STRATEGIC study (Strategies to increase cervical screening uptake at first invitation) to identify methods to help increase uptake among women. The STRATEGIC study will be publishing findings in May 2016, more details of this can be found at:

http://www.nets.nihr.ac.uk/projects/hta/0916401

The cervical cancer screening programme was established on the basis that it would prevent, and lead to the early diagnosis of, cervical cancer reducing the number of premature deaths.^[1]

No assessment has been made of the financial consequence to the NHS on the low uptake of cervical screening. However, cost-effectiveness is a key criteria of the UK National Screening Committee recommending whether or not screening for a particular condition should take place. For example, a cost-effectiveness evaluation of the current pilot of human papillomavirus (HPV) testing as primary cervical screening is being undertaken alongside the clinical evaluation of the pilot. Cancer Research UK has estimated that, when fully implemented, HPV testing as primary screening could prevent an additional 600 cancers a year.^[2]

[1] Peto et al, The cervical cancer epidemic that screening has prevented in the UK, Lancet 2004; 364: 249-56

[2] http://msc.sagepub.com/content/early/2013/06/10/0969141313492313