§ Mrs. Dunwoodyasked the Secretary of State for Social Services whether cervical smear tests are provided by general practitioners on an item of service basis.
§ Mr. Kenneth ClarkeYes, if they are taken at the appropriate time from priority group women. Fees are payable for the initial smears and repeat smears every five years on all women of 35 and over and women under 35 who have been pregnant on three or more occasions.
Number of cervical smear tests taken in England and Wales, 1977–1981 Thousands Source of Smear Year Total Smears taken by GPs Smears taken at Family Planning Clinics Other source 1977 2,545 952 389 1,204 1978 2,587 958 388 1,241 1979 2,749 1,065 374 1,310 1980 2,928 1,252 356 1,320 1981 2,999 1,417 349 1,233
§ Mrs. Dunwoodyasked the Secretary of State for Social Services what is his policy on the use of cervical smear tests for the detection of cancer.
§ Mr. Kenneth ClarkeA cervical smear test will only detect cancer of the cervix. There is a well-established programme of cervical screening which is designed to reduce mortality from cervical cancer. Present policy, based on the advice of the Committee on Gynaecological Cytology (CGC), lays emphasis on the screening every five years of the priority group of women aged 35 and over and those who have been pregnant on three or more occasions. For younger women a cytological examination should be taken in each pregnancy; women attending for family planning advice should have a first test at age 22 or at the next visit after that age; for women who continue to attend for family planning advice a further test should be taken at age 30 if 5 years or more have elapsed since the preceding test.
Any woman between the ages of 22 and 35 who does not come within any of these categories should be screened twice if she requests it. In the light of recent research findings we have accepted the advice of the CGC that, as an interim measure, in the absence of fuller information on the relationship between cervical cancer and oral contraceptives, any sexually active woman who requests oral contraceptives should have a cervical cytological examination when oral contraceptives are initially prescribed; and further cervical cytological examination should be taken at ages 20, 25 and 30 for users and ex-users of oral contraceptives unless a cytological examination has already been undertaken for another purpose during the past five years, for example during pregnancy.
§ Mrs. Dunwoodyasked the Secretary of State for Social Services what is the total annual cost and the cost per patient of cervical smear tests.
§ Mr. Kenneth ClarkeInformation on total annual cost to the NHS is not available as smears are taken in many different parts of the service and costs vary from place to place.
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§ Mrs. Dunwoodyasked the Secretary of State for Social Services (1) how many women have had cervical smear tests in each of the last five years;
(2) how many cervical smear tests were carried out in each of the last five years by (a) general practitioners and (b) family planning clinics.
§ Mr. Kenneth ClarkeThe available information is given in the table. Figures held centrally are of the number of tests rather than the number of women tested. Figures for 1983 are not yet available.