CervicalCheck: counties with highest and lowest screening uptake revealed

First report since pandemic shows how restrictions affected delivery

The uptake of cervical screening by women is lowest in counties Laois, Kilkenny, Clare, Dublin and Mayo, according to the first report published by CervicalCheck since before the pandemic.

The uptake rates were tracked over five years from 2017 to 2022 and show they are as low as 60pc in Laois, 61pc in Kilkenny, 63pc in both Clare and Dublin and 64pc in Mayo.

Coverage is highest in Carlow at 75pc, followed by Wicklow at 74pc and Westmeath reporting 73pc. It is also 70pc or over in Wexford, Waterford, Meath, Louth, Leitrim, Kildare and Carlow. The national uptake during that time was 73pc. Uptake for screening is also highest among those aged 25-29 and lowest among the over 60s.

The new report covers April 2020 to March 2022 and highlights the impact of Covid-19 restrictions on the delivery of cervical screening, including pausing screening for three months in 2020.

Invitations were resumed in July 2020, first calling women considered to be at higher risk, while the capacity available to deliver follow-up care to women who attended screening also had to be managed. It said: “Over the two-year period we focused on delivering our service safely and to as many people as possible. Despite the challenges, by the end of 2021 we had screened the same number of women in the two-year period of the pandemic as in any other two-year period.”

There has been a relative increase in the detection of low-grade abnormalities and “this is a positive impact of the change to primary HPV screening”, the report said. Women who are found to have HPV but have no abnormal cells are called back after one year for another HPV test.

Between April 2020 and March 2022 a total of 526,816 women were screened: 88.8pc of women screened tested negative for HPV while the prevalence of HPV among the screened population is 11.2pc.

The programme aims to send 90pc of results to women within four weeks. From 2020 to 2022, 61pc of women received their results within four weeks, while 90pc got them within six weeks.

Laboratory turnaround times during this period were impacted by Covid and the cyber attack on the HSE.

Over one-third of women who tested positive for HPV had low-grade abnormalities detected, with 7.6pc found to have high-grade abnormalities.

Around 44pc of women or 26,408 who were referred for further examination (colposcopy) had a cervical biopsy taken.

Of these, 63pc had low-grade abnormal cells detected, the majority of which did not require treatment. A total of 36.3pc had high-grade abnormalities detected, while 187 women were diagnosed with cervical cancer in colposcopy.

Around 100 women are diagnosed with cervical cancer in colposcopy clinics each year. Half are diagnosed at stage 1A and are treated under local anaesthetic during an outpatient visit in the colposcopy clinic setting.

The remainder are diagnosed at a higher stage and are referred to gynaecology services for treatment, according to the report.

‘Uptake is highest among those aged 25-29 and lowest among the over-60s’