Section 8 - Cervical Screening Wales

Cervical Screening Wales aims to reduce the incidence of, and morbidity and mortality from, invasive cervical cancer. Women and people with a cervix are invited every 3 years from the age of 25-49, with optimisation of the screening interval to 5 years for all ages starting from January 2022. Women aged 50-64 are invited every 5 years.

Following the pause in screening programmes in March 2020, participants were invited for cervical screening as part of a phased restart from June 2020 to March 2021. The programme recovered post-pause in December 2021.

Coverage of cervical screening across Wales is defined as the proportion of eligible participants who received an adequate test in the appropriate time period for their age. As of October 2022, coverage across Wales is 69.6%. This is almost the same as in 2020/21 where the figure was 69.5%. This has declined from 73.2% reported in 2019/20. The minimum service standard for coverage is 70%.

8.1: Uptake of Cervical screening by geographical area

There was some geographical variation in coverage across Wales at health board level.  Coverage was lowest in Cwm Taf University Health Board (CTMUHB) at 68.3% and highest in Swansea Bay UHB at 72.8% (Table 4). 

Table 4: Coverage (%) of cervical screening by health board of residence, 2021/2

There is greater variation in coverage of cervical screening at local authority area. Coverage of cervical screening is lowest in Cardiff with an uptake of 66.3%, and highest in Monmouthshire of 75.4% (Figure 9).

Figure 9: Coverage (%) of cervical screening by local authority of residence, 2021/22

Description of Figure 9:  Bar chart showing the pattern of cervical screening uptake in each of the 22 local authorities. This ranges from 75.4% in Monmouthshire to 66.3% in Cardiff.

8.2: Coverage of cervical screening by deprivation

Across Wales, in 2021/22, coverage of cervical screening was highest in the least deprived areas at 75.9%, with coverage lowest in the most deprived areas at 62.7%. The inequity gap, representing the absolute difference between coverage in the least deprived communities compared to the most deprived communities was 13.2%, an increase in 1% from the year before as uptake in Quintile 1 has increased slightly whereas uptake in quintile 5 has decreased slightly.

Figure 10: Coverage of Cervical Screening by deprivation quintile – all Wales 2021/22

Description of Figure 10: Bar chart showing how cervical screening coverage decreases as level of deprivation increases. Uptake in the least deprived group is 75.9% but 62.7% in the most deprived group.

This association between coverage and deprivation is broadly seen across all health board areas in Wales, although the pattern is not linear in Cardiff and Vale University Health Board and uptake is highest in Quintile 2 in Hywel Dda University Health Board. The inequity gap ranged from a highest of 14.6% in Cardiff and Vale to the lowest of 10.9% in Hywel Dda.

Figure 11: Coverage of Cervical Screening by deprivation quintile by health board 2021/22

Description of Figure 11: Clustered Bar chart showing the pattern of cervical screening coverage by deprivation in each of the seven health boards. The overall pattern shows that uptake decreases as deprivation increases.

8.3: Uptake of cervical screening by Age

Across Wales in 2021/22, coverage of cervical screening is lowest in the youngest age group (25-29 years) eligible for screening. Coverage of eligible participants aged 25-29 is 64.8% (up by 1.4% from last year) compared to the highest coverage of 77% in participants aged 50-54 (was 77.2% in 2020/21).

Figure 12: Coverage of Cervical Screening by age group – all Wales 2021/22

Description of Figure 12: Bar chart comparing cervical screening coverage by age groups showing that uptake is lowest in the youngest and oldest age groups and is highest in women aged 50-54.

The trend for lower uptake in younger age groups is present across all health boards in Wales.