Cervical screening incident

Every year, the NHS in Scotland reviews all cervical screening records of people diagnosed with cervical cancer. The name of this review is the National Invasive Cancer Audit.

The audit found a small number of people (fewer than 5) diagnosed with cervical cancer following a hysterectomy, who had been excluded from cervical screening (smear tests).

These people shouldn't have been excluded from cervical screening. They'd had a subtotal hysterectomy, meaning their cervix (neck of the womb) wasn't removed.

To make sure this issue hadn't affected anyone else, a review of records held on the screening system was carried out. This showed that further investigation was needed.

The NHS is in the process of contacting everyone affected by the error. There's no need for you to contact anyone. 

Types of hysterectomy

A total hysterectomy removes the womb (uterus) and cervix. If you've had a total hysterectomy you'll be removed from the cervical screening programme and you'll no longer receive cervical screening invitations.

A subtotal (or partial) hysterectomy only removes the womb. If you've had a subtotal hysterectomy, you should still receive invites for cervical screening.

Less than 1 in every 100 people with a cervix (less than 1%) in the UK will develop cervical cancer in their lifetime.

What investigation was carried out?

People with a record of having had a subtotal hysterectomy who'd been excluded from cervical screening were identified. Their hospital, laboratory, GP and screening records were checked to make sure they'd been correctly excluded.

What did the investigation find?

Some people's records showed a total hysterectomy had taken place and their cervix was removed during the operation. These people had been correctly excluded from screening. No further action was needed for this group.

Some people's records showed a subtotal hysterectomy had been carried out. This means their cervix wasn't removed during the operation. These people shouldn't have been excluded from cervical screening.

This group received an apology letter. If they were within the eligible age range, they were also invited to contact their GP practice to make a cervical screening appointment. Those over the eligible age range were invited to attend an appointment with a gynaecologist to find out if they needed cervical screening.

In some people's records, it wasn't clear what type of hysterectomy was undertaken. This means it wasn't possible to know if the person's cervix was removed during their operation. These people were invited to attend a medical appointment with a gynaecologist to find out if they needed to have cervical screening.

What investigation is still needed?

The records of everyone excluded from cervical screening are being reviewed to ensure these people were excluded correctly. There are 199,000 records to review (as of October 2021). It’s expected that the investigation will take at least until October 2022 to complete.

While this may sound like a long time, most people who have been excluded from cervical screening have been excluded correctly.

Around 95% of hysterectomies performed in Scotland are total - this means that the peron's cervix is removed and they no longer need cervical screening.

As the investigation goes on, the NHS will contact anyone who's been wrongly excluded.

Everybody whose records are being reviewed will be kept up to date.

How do I find out if I've been wrongly excluded?

If you've been wrongly excluded from screening the NHS will contact you. There's no need for you to contact anyone.

Anyone who's concerned should contact the helpline provided by Jo’s Cervical Cancer Trust for further help and support.

The records of people excluded from cervical screening will be reviewed.

As the records are being reviewed, the NHS will contact and assess those identified as being wrongly excluded. The people affected will be informed about how the review is progressing and when it's likely to be completed.

The review will start with the records of those people who've waited for the longest without screening. The risk of developing cervical cancer is low, but it increases with the amount of time that's passed since your last cervical screening test.

Urgent advice: Contact your GP straight away if you experience any of the following symptoms:

  • unusual discharge
  • bleeding after sex, between periods or after the menopause

These symptoms are usually caused by something other than cervical cancer but it's important to have them checked.

Is anyone else likely to be wrongly excluded?

Before excluding anyone from cervical screening, the laboratories now do an extra check with the doctor who carried out the hysterectomy. This is to make sure that the person's cervix was completely removed during their hysterectomy.

GPs can't exclude anyone from screening, and this will remain the case until more safety measures are in place.

Further information

If you've any general questions about cervical screening, cervical examinations or hysterectomies, you can contact Jo’s Cervical Cancer Trust.

In partnership with NHS Scotland, Jo’s Cervical Cancer Trust has made its national helpline available to anyone with concerns.

You can visit jostrust.org.uk, call the free helpline on 0808 802 8000, or email helpline@jostrust.org.uk.

Jo’s Cervical Cancer Trust doesn't have access to NHS records so they won't be able to provide you with clinical information about your screening history or hysterectomy.

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Source: Public Health Scotland

Last updated:
30 November 2021