Reviewing your Cervical Screening History

Reviewing your Cervical Screening History

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

We review the cervical screening history of everyone diagnosed with cervical cancer
to see that any cervical screening tests and investigations have been carried out in
line with NHS Cervical Screening Programme standards. Reviews are an essential
part of every high-quality screening programme and are a routine part of the cervical
screening process. Information we gather from individual cases helps to improve the
programme and learn more about how cancers develop and how they are
diagnosed.

Whilst regular cervical screening is the best way to reduce the risk of developing
cervical cancer by detecting abnormal cells on the cervix early on, like all screening
tests it is not perfect. Abnormal cells can be missed, even in the best performing
screening programmes which meet all the quality standards.

If you would like to know the results of your cervical screening history review, please
fill in your response form and return it to us. The review is likely to take at least 6
months to complete. We will contact you when your results are available, and
arrange a convenient time for you to come and discuss them with your hospital
doctor.

The cervical screening history review

We review all records connected to your cervical screening history from the past 10
years. This includes your invitation letters, cervical screening tests, result letters and
any medical investigations related to cervical screening. A group of professionals
will look again at your previous tests and your medical notes related to cervical
screening.

Cervical screening has recently changed to human papillomavirus (HPV) primary
screening. All screening samples that are HPV positive (contain HPV) are put onto a
slide to be checked under a microscope for abnormal cells (cytology). These
cytology slides will be reviewed. We are not able to review samples that are only
HPV tested (not put onto a slide), as they are not kept.

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

Cancer detection

Screening history reviews usually find that a cervical cancer has been found at the
earliest possible stage. Although cervical screening prevents most cervical cancers
(about 7 out of 10), it cannot prevent all of them. The review process aims to
highlight any areas which could be improved in the future. Some examples of issues
that can be found are described below.

Identifying abnormal cells

Screening cannot always identify abnormal cells on a cytology slide because:

• sometimes abnormal 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 not identify the abnormal cells (this happens
  occasionally, no matter how experienced the reader is)

Colposcopy
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 sampled in a biopsy (a small tissue sample)
• the abnormal cells might be hidden higher up inside the cervix
• some types of abnormality are very difficult to identify at a colposcopy

How we use your information
We routinely collect and review screening information as part of an ongoing audit
process. This is carried out confidentially. Your information (without your name)
helps us make improvements and discover more about how cancers develop and
how to better diagnose and treat them. The audit is done whether or not you want to
know the results of the review.

Why we offer cervical screening
Cervical screening reduces the risk of developing cervical cancer by treating
abnormal cells before they can develop into cancer. The cervical screening
programme saves thousands of lives a year in England.

Next steps in your cervical screening history review
Please fill in the review results response form and return it to us. When the review is
complete, we will contact you to let you know. If you wish to know the results, we will
arrange for your hospital doctor to meet with you to discuss them in detail.

We understand this is a difficult time and it is completely up to you to decide whether
you want to know the results of your review.
If you decide you do not want to know your results now, you can change your mind
at any time and contact your hospital doctor or GP. They will make arrangements for
you to receive your results.

Please note that unless you give us permission, we cannot give your review results
to your relatives.

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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