Cervical Cancer Screening (Hansard, 28 October 1996)

§ Mr. Cousins
To ask the Secretary of State for Health (1) what guidance he has issued as to the acceptance by NHS pathologists as adequate of cervical cancer screening test record cards that do not confirm that visual inspection has taken place; [457]
(2) if he will place in the Library copies of the guidance he has issued about the adequacy and competence of cervical cancer screening tests; [393]

Number of adequate smears examined by pathology laboratories in England 1990–91 to 1994–95

1990–91 1991–92 1992–93 1993–94 1994–95

Total adequate smears¹(thousands) Percent of results requiring follows² Total adequate smears¹(thousands) Percent of results requiring follows² Total adequate smears¹(thousands) Percent of results requiring follows² Total adequate smears¹(thousands) Percent of results requiring follows² Total adequate smears¹(thousands) Percent of results requiring follows²

England 3949.2 7.0 4252.0 7.1 4055.0 7.1 4131.0 7.9 4150.2 8.5

Regional health authority

Northern 296.2 6.3 302.0 5.7 306.7 6.2 274.2 6.5 287.1 8.2

Yorkshire 227.0 6.2 271.9 5.4 265.3 4.8 302.1 6.4 326.3 7.3

Trent 419.2 5.5 418.2 5.7 398.6 5.8 300.9 7.2 416.0 8.0

East Anglia 134.3 5.5 163.2 5.6 167.6 5.7 174.7 6.3 177.9 8.1

North West Thames 236.0 4.7 321.7 7.3 292.7 6.5 434.7 7.0 302.7 7.9

North East Thames 340.0 9.4 350.0 8.9 329.6 6.4 348.0 7.2 324.8 7.9

South East Thames 261.4 7.1 299.8 7.4 299.7 7.5 286.0 7.2 300.5 7.2

South West Thames 236.2 6.3 250.5 6.1 243.3 6.1 267.5 7.7 291.5 8.3

Wessex 193.0 5.4 243.7 6.4 239.4 6.3 265.8 8.8 244.6 9.2

Oxford 244.6 11.9 237.9 8.3 223.3 7.4 228.9 7.0 228.2 8.2

South Western 254.2 8.3 306.6 7.5 222.4 7.7 233.1 10.2 239.8 9.5

West Midlands 483.8 6.8 494.2 7.9 491.0 8.4 436.9 8.5 422.3 8.6

Mersey 223.1 8.0 208.8 8.0 201.4 8.0 170.2 8.1 219.3 8.4

North Midlands 400.2 5.1 383.4 11.2 373.9 12.2 407.9 11.6 369.5 11.6

Excludes smears found to be inadequate

Includes all smears tested found to be positive or abnormal.

The information is obtained from the central return KC61 which collects information about cervical smears examined by pathology laboratories. The date inlcude all cervical smears examined for whatever reason ie symptomatic as well as screening programme smears.

38W
(3) what representations he has received as to the adequacy of cervical cancer screening tests where no visual inspection of the cervix has taken place. [494]

§ Mr. Horam
In October 1995, a working party of the Royal College of Pathologists, the British Society for Clinical Cytology and the national health service cervical screening programme produced guidelines entitled "Achievable Standards, Benchmarks for Reporting and Criteria for Evaluating Cervical Cytopathology". These guidelines were launched by the chief medical officer in March this year, together with two further sets of guidelines relating to cervical screening: "Quality Assurance Guidelines for the Cervical Screening Programme" and "Standards and Quality in Colposcopy", and issued to the NHS. No specific representations have been received as to the adequacy of cervical screening where no visual inspection has taken place. However, the importance of visual inspection is emphasised in the British Society for Clinical Cytology's training video and booklet for smear takers "Taking Cervical Smears", which was promulgated to the NHS under cover of EL(94)33. Copies of all guidance documents relating to cervical screening are available in the Library.

§ Mr. Cousins
To ask the Secretary of State for Health how many cervical cancer screening tests were carried out in each health authority area since 1990, indicating in each case the percentage of cases requiring follow-up. [501]

§ Mr. Horam
Information on cervical screening tests is collected from pathology laboratories and is not held at district health authority level. The number of adequate smears examined by pathology laboratories in England in the years 1990–91 to 1994–95 is shown by region in the table. Questions relating to cervical screening in Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.

Number of adequate smears examined by pathology laboratories in England 1990–91 to 1994–95
	1990–91	1991–92	1992–93	1993–94	1994–95
	Total adequate smears¹(thousands)	Percent of results requiring follows²	Total adequate smears¹(thousands)	Percent of results requiring follows²	Total adequate smears¹(thousands)	Percent of results requiring follows²	Total adequate smears¹(thousands)	Percent of results requiring follows²	Total adequate smears¹(thousands)	Percent of results requiring follows²
England	3949.2	7.0	4252.0	7.1	4055.0	7.1	4131.0	7.9	4150.2	8.5
Regional health authority
Northern	296.2	6.3	302.0	5.7	306.7	6.2	274.2	6.5	287.1	8.2
Yorkshire	227.0	6.2	271.9	5.4	265.3	4.8	302.1	6.4	326.3	7.3
Trent	419.2	5.5	418.2	5.7	398.6	5.8	300.9	7.2	416.0	8.0
East Anglia	134.3	5.5	163.2	5.6	167.6	5.7	174.7	6.3	177.9	8.1
North West Thames	236.0	4.7	321.7	7.3	292.7	6.5	434.7	7.0	302.7	7.9
North East Thames	340.0	9.4	350.0	8.9	329.6	6.4	348.0	7.2	324.8	7.9
South East Thames	261.4	7.1	299.8	7.4	299.7	7.5	286.0	7.2	300.5	7.2
South West Thames	236.2	6.3	250.5	6.1	243.3	6.1	267.5	7.7	291.5	8.3
Wessex	193.0	5.4	243.7	6.4	239.4	6.3	265.8	8.8	244.6	9.2
Oxford	244.6	11.9	237.9	8.3	223.3	7.4	228.9	7.0	228.2	8.2
South Western	254.2	8.3	306.6	7.5	222.4	7.7	233.1	10.2	239.8	9.5
West Midlands	483.8	6.8	494.2	7.9	491.0	8.4	436.9	8.5	422.3	8.6
Mersey	223.1	8.0	208.8	8.0	201.4	8.0	170.2	8.1	219.3	8.4
North Midlands	400.2	5.1	383.4	11.2	373.9	12.2	407.9	11.6	369.5	11.6
Excludes smears found to be inadequate
Includes all smears tested found to be positive or abnormal.
The information is obtained from the central return KC61 which collects information about cervical smears examined by pathology laboratories. The date inlcude all cervical smears examined for whatever reason ie symptomatic as well as screening programme smears.