West Midlands Cervical Screening Programme

National Invasive Cervical Cancer Audit

The NHS Cervical Screening Programme (NHSCSP) has launched a national audit of all invasive cervical cancers diagnosed from 1 April 2007. The purpose of the audit is to monitor the effectivenes of the screening programme, to identify areas of good practice and situations where improvements can be made. The audit will provide information for patients on how their cancer may have developed as well as important knowledge for local and regional screening programmes.

The audit is co-ordinated regionally by each Cervical Screening QA Reference Centre in England. Information related to each cancer diagnosed is collected from laboratories, colposcopy clinics, general practices and Primary Care Trusts (PCTs) and covers records of cervical screening invitations, cytology tests, biopsy specimens and colposcopy appointments in the ten years prior to diagnosis. Where tests have been taken or hospital visits have occurred, these records will be reviewed again by health professionals in the hospital. Under certain circumstances, these records may also be reviewed anonymously by a group of health professionals not working in the hospital Trust that diagnosed the cancer.

As part of the audit, each cancer case is allocated a "screening status". The screening status categories used nationally have been developed from work carried out in the West Midlands. For more details on this work go to the cervical screening histories project section below.

Once all the information has been obtained, it will be provided to the patient if she has indicated that she wishes to know the results. Data are also sent, in a form which does not identify the patient, to Cancer Research UK for national analysis.

NHSCSP guidance on the audit and advice on disclosing the results of audit can be found at NHSCSP Publication No 28 and NHSCSP Disclosure of Audit results in Cancer Screening. Further information on the disclosure of audit results in the West Midlands can be found by clicking here.

Cervical Screening Histories Project

The NHS Cervical screening Programme aims to reduce the number of cases of invasive cervical cancer. Although screening cannot prevent every case of cervical cancer, it is essential when monitoring the performance of the programme, to look at the sort of screening history the women who are diagnosed with invasive cervical cancer have. Some women may never have been screened, whilst some may have regular records of screening attendance. Of those women that have been screened, some may have always had negative screening tests and some may have had a number of abnormal tests in the past. These types of data provide the regional and national screening programmes with important information which can be used to audit the West Midlands cervical screening programme and monitor changes in the distribution of screening histories over time. Both of these activities will improve the programme for all women.

The Cervical Screening QA Reference Centre works closely with the cancer registration and information service at the West Midlands Cancer Intelligence Unit to obtain the details of all women diagnosed with invasive cancer in the West Midlands for the audit. The screening histories are then routinely obtained using a computer link to PCT screening databases, are classified and then passed back to the cancer registration service with the screening classification attached in order to fulfil national cancer registration requirements. The Cervical Screening QA Reference Centre then uses the detailed information obtained in its routine quality assurance activities. The Cervical Screening QA Reference Centre has developed an original classification system for this work which has been published in the Journal of Medical Screening 2006;13: 137-147 (Number 3).

This work involves the use of confidential data. All necessary steps are taken to ensure confidentiality at all times. Further information on these arrangements and the national approval process which allows these activities can be found by clicking here