Subject 1: the NHS (NHSCSP) cervical screening program

1 and 1 Subject 1 Learning objectives

The trainee should know:

• Population screening programs
• The objective of the NHS cervical screening program (NHSCSP))
• The history of NHSCSP
• current statistics and important elements of the program's success

The trainee must understand:

• influences on adoption
• The obstacles that prevent people from attending their cervical screening test and the means to overcome these
• recommended routine screening intervals
• Why should not be done

1.1 Guidance for the coach

Indicate the trainee with reading and resources on all subjects in this section, in particular:

2 Population screening programs

We provide information on all Population screening programs.

We also host:

3 and 3 Objective of the NHS cervical screening program (NHSCSP))

The goal of NHSCSP is to reduce the number of people who are developing cervix from the cervix invasive (incidence) and the number of people who die (mortality). He does so by providing regular screening for people aged 24.5 to 64 who have a cervix.

3.1 History of the cervical screening program

Important milestones in the NHSCSP include:

• 1960: Cervical screening started
• 1988: the NHSCSP was configured with the introduction of computer and recall computerized systems
• 2004: the introduction of cytology based on liquid (LBC), which has considerably reduced the quantity of inadequate cervical screening results
• 2008: the introduction of national HPV vaccination program
• 2012: the introduction of HPV Sorting and healing test
• 2019: the introduction of primary HPV Test in England to replace cytology as the main screening test
• 2019: the HPV Vaccine systematically offered to boys aged 12 to 13
• 2025: the routine screening interval for people with a Hrhpv The negative result went to 5 years for all ages

3.2 Current statistics and program success

Refer to the last Cervical screening statistics For:

• The total number of people aged 25 to 64 invited for screening in England
• The number of elderly people up to 65 was tested in England
• The percentage of eligible people aged 25 to 64 was detected at least once in the previous 5 years

Important elements in the success of the program

The notable achievements and functions of the screening program include:

• The identification and invitation of all people eligible for appropriate screening intervals (eligible people are individuals aged 24.5 and 64 who have a cervix)
• the realization of At least 80% coverage of eligible individuals
• the availability of information so that people help them make a Lighted choice on screening
• An operating model that describes the quality insurance processes supported by clear administrative and clinical protocols
• recognize and help fight obstacles to screening
• be aware of the psychological aspects of intimate examinations

4 The experience of screening for the individual

The lessee sample plays a crucial role in the experience of the individual. This includes:

• Work together to solve all anxieties and make them comfortable
• Attack their individual needs both physically and psychologically
• Give specific information to make an informed choice
• offering a positive cervical screening experience
• Explain, discuss and act on the results
• Possible processing options if the results are abnormal

Negative cervical screening experience frequently leads to anxiety about the procedure itself and could potentially prevent a person from choosing to react. Poor information can cause confusion and anxiety concerning HPV (His links with the cause of cervical cancer and risk factors around his contract).

5 Obstacles to cervical screening

Problems that can make people difficult to attend cervical screening include:

• accessibilityIncluding the availability of appointments, finding time to attend (get an appointment at a timely time) and the choice of the place where to be detected (like a sexual health clinic or GP surgery))
• Fear of having the test, due to embarrassment, the fear that the test be painful, a poor experience previous to screening, postnatal concerns due to trauma during birth, or history of sexual assault or rape
• feel pain or discomfort during the test (this especially a problem for menopausal people)
• not understanding the relevance of screening, the role of HPV in cervical cancer, or how screening helps prevent cancer
• Linguistic barriers, cultural and religious beliefs, community or social pressure and stigma
• Sexual orientation and other gender -related problems (for example lesbian women have said that they do not need screening)

6. Routine screening intervals

Refer Guidance on cervical screening intervals. A Primary preview HPV screening supports these tips.

6.1 First and following invitations

We send a first invitation to a routine screening 6 months before the person is 25 years old.

We send all the subsequent invitations around 6 weeks before the next date of maturity of the person's test.

A period of several months may occur between the issuance of invitations to people and the date of their screening test. The sending of invitations long before the deadlines of tests reduces the possible delays.

6.2 Transgender men (trans)

Trans men who still have a cervix are eligible for screening. Trans men registered with their general practitioner as a woman will receive automatic screening invitations. Translaws recorded as men do not receive an invitation, but remain in the right to detect and should organize an appointment with their GP practice every 5 years.

6.3 People under the age of 24.5

We do not invite people under the age of 24.5 for cervical screening because:

• Cervical cancer is very rare in people under the age of 25
• High -risk human papillomavirus infection (Hrhpv) is very common in people under the age of 25 and can cause abnormal changes to collar cells (for most people, these cervical anomalies will regress as the immune system erases the HPV infection)
• An abnormal screening result and treatment of cervical anomalies can cause anxiety to many people
• The International Agency for Research on Cancer (Ciri) recommends that people do not start cervical screening before the age of 25
• In 2012, the UK NSC advised the NHSCSP This screening under 25 does more harm than good and has recommended a coherent age of screening throughout the United Kingdom (from June 2016, the 4 nations are from 25 years old)
• The number of young people diagnosed with cervical cancer is likely to reduce the NHS HPV Vaccination program introduced in 2008

6.4 People over 64

We do not invite people over 64 for cervical screening because:

• The natural history and the progression of cervical cancer of the uterus means that it is very unlikely that these people continue to develop the disease; People aged 65 and over who have suffered 3 consecutive negative tests are removed from the call and recall system
• People aged 65 and over who have never been detected or have an incomplete screening file are entitled to a test if it requires one

6.5 People who are not sexually active

THE NHSCSP Invites all eligible people aged 24.5 and 64 for cervical screening. If a person has never had sexual contact with a man or a woman, research shows that their chances of developing cervical cancer are very low. It is no “risk”, only a very low risk. In these circumstances, an individual could choose to refuse his invitation to cervical screening.

The term “sexual contact” includes:

• Vaginal, oral or anal sex
• Any skin to skin contact that includes the genital area
• Share sex toys

If a person is not currently sexually active but has had sexual partners in the past, we recommend continuing to attend the selection.

7 People under the age of 24 with abnormal vaginal bleeding

Guidance of the Ministry of Health and Social Coins (DHSC) on Management of women below the age of screening that has symptoms of cervical cancer declares that people with vaginal bleeding after sex and or between periods require a pelvic examination.

A qualified nurse, a registered doctor can perform a speculum exam. A trained GP can perform a pelvic exam.

Vaginal bleeding is extremely common and can have a range of causes, including normal conditions such as:

• Cervical Ectropion
• Hormonal changes due to the contraceptive pill
• Mild cervical polyps
• Sexually transmitted infections such as chlamydia

THE DHSC advice Explain the types of questions whose examples of takers should ask people to determine whether their symptoms are linked to cervical cancer.

8 Non NHS cervical screening tests

People with a private sample are eligible for screening in the NHS at the standard intervals. As the NHS cannot guarantee private quality tests, the results of non -NHS tests are not recorded in the NHS screening file of a person.

9. Unforeseen cervical screening tests

Do not perform additional tests if a person is in the screening age group and has undergone a test in the previous routine screening interval (3 to 5 years).

Additional tests should not be carried out for someone because they:

• attend advice or contraceptive services
• attend advice on replacement hormone therapy
• are pregnant or attend postnatal services
• have genital warts
• have a vaginal outing
• have an infection
• had several sexual partners
• are heavy cigarette smokers
• have family history of cervical cancer

The laboratory will not accept unforeseen samples and will reject the test in accordance with the National guidance on the acceptance of samples. The lessee sample must explore the reason (s) for the person requesting screening and, if necessary, examine and refer accordingly.