Cervical Screening Programme, England - 2019-20 [NS]

• 191,563 referrals to colposcopy were reported in 2019-20, an increase of 5.1% from 2018-19 (182,304).
• 66.0% of referrals were reported as being triggered by a screening test.
• 27.2% of referrals were clinically indicated (women referred because they had symptoms of a cervical abnormality).
• The proportion of referrals for ‘other’ reasons decreased from 7.8% in 2018-19 to 6.9% in 2019-20.

For further information see data table 20 in the Excel data tables file.

Time from referral to first offered appointment is defined as the time between the date on the referral letter and the first offered outpatient appointment, regardless of whether the appointment was attended or not¹.

In 2019-20:

• 36.1% of women were offered an appointment within 2 weeks of referral. This compares to 38.1% in the previous year.
• 60.7% of women were offered an appointment within 4 weeks of referral. This compares to 65.6% in the previous year.
• 93.7% of women with a referral type of ‘High-grade dyskaryosis moderate/severe’ were offered an appointment within 2 weeks.
• 93.9% of women with a referral type of ‘High-grade dyskaryosis moderate or worse’ were offered an appointment within 2 weeks. This meets the programme standard for at least 93% of women to be offered an appointment within 2 weeks².
• In 1.1% of cases, the time from referral to first offered appointment was over 12 weeks (see table below)

* ?invasive carcinoma means ‘suspected invasive carcinoma’, ?glandular neoplasia means ‘suspected glandular neoplasia of endocervical type’.
Source: KC65, NHS Digital. See data tables 20 and 21

In 2019-20: 

• 71.4% of all appointments were attended
• 2.2% of appointments were cancelled by patients on the day
• 7.5% of appointments involved the patient not attending with no advance warning
• The lowest attendance was seen for follow up appointments (64.0%)

NB. The sum of components may not equal totals due to rounding.
Source: KC65, NHS Digital. See data table 22
.

Most first attendances will relate to a referral in that year, although some women attending may have been referred in a previous year and some of the women referred in 2019-20 will attend in the next year.

The data collected relate only to procedures undertaken the first time a woman attends. 

In 2019-20:

• 55.0% of all women attending for the first time had some treatment or procedure
• For all referrals, the most common treatment or procedure was diagnostic biopsy (43.5%)
• The most common treatment differed between referrals for borderline or low-grade abnormalities (diagnostic biopsy – 55.0%) and high-grade abnormalities (excision – 50.3%)

NB: The sum of components may not equal totals due to rounding.
* Includes ‘other’ referral indications that cannot be broken down into a specific category.
** Includes ?invasive carcinoma which means ‘suspected invasive carcinoma, and ?glandular neoplasia which means ‘suspected glandular neoplasia of endocervical type’.
Source: KC65, NHS Digital. See data table 23
.

In 2019-20:

• The percentage of all women receiving some treatment or undergoing a procedure ranged from 48.0% in the North West to 68.1% in the North East.
• Diagnostic biopsy was the most common procedure used across all regions, ranging from 34.1% of attendances in the North West to 55.4% in the North East.
• Excision was the next most common procedure, ranging from 1.2% in London to 13.9% in the South East.
• See Table 23 in the Excel data tables file for a full breakdown of the data by region, type of procedure and referral indication.

This is the time between the date on which the biopsy was taken and the date on the letter that is sent to the patient.

In order to allow time for follow up of results, the data relates only to those biopsies taken in the first month of each quarter.
The data include all biopsies taken, not just those taken from women on first attendance. It is possible that more than one biopsy may be taken from the same woman.

There are 2 national standards relating to timeliness of biopsy result letters.

1. Acceptable level: At least 90% of result letters sent within 4 weeks.
2. Achievable level: 100% of result letters sent within 8 weeks.

In 2019-20:

• 50,240 biopsies with a time to result recorded, were reported by clinics in the 4 sample months.
• The woman was informed of her result within 2 weeks in 33.8% of all cases, and in 48.1% of cases, women were informed within 2 to 4 weeks.
• In 0.5% of cases, women had not been informed of their results within 12 weeks. This figure includes cases where the result had not yet been reported to the clinic.
• Neither national standard was met in 2019-20. 81.9% of letters were sent within 4 weeks, and 98.3% with 8 weeks.

Of all biopsies reported in 2019-20 with an outcome recorded (50,233), 68.9% were diagnostic and the remaining 31.1% were classed as non-diagnostic (excisional – 29.3%, other non-diagnostic – 1.9%)

Excisional biopsies represent treatment to remove abnormal cells from the cervix. The outcome of most of these is therefore expected to be CIN2 or worse (CIN2, CIN3, adenocarcinoma in situ or cancer).

Of all known non-diagnostic biopsy outcomes, 72.5% showed CIN2 or worse. This is a decrease from 2018-19, when the equivalent proportion was 73.6%.

NB: The sum of components may not equal totals due to rounding.
Source: KC65, NHS Digital. See data table 25.

1. This could include instances where patients had requested a delayed appointment for personal reasons or where treatment for another condition had to be completed before colposcopy could take place.
2. See https://www.gov.uk/government/publications/cervical-screening-programme-standards/cervical-screening-programme-standards-valid-for-data-collected-from-1-april-2018