Fewer repeat smear tests required

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Fewer women in England are having to return for repeat cervical screening because of an inadequate first test.

An Information Centre for health and social care analysis shows a new method for taking smears has significantly reduced the number of inadequate tests.

Liquid-based cytology (LBC) is now used by the NHS Cervical Screening Programme instead of standard pap smear tests.

In 2005-06, the proportion of inadequate tests among women aged 25 to 64 fell from 9% to 7.2% of the total.

These figures are extremely encouraging as they show that women are already benefiting from the new technology Julietta PatnickNHS Cancer Screening Programmes

This is the first time since 1998 that the percentage of inadequate tests has fallen.

In total laboratories examined four million samples during the year, supplied from all sources and for women of all ages. Of these nearly 250,000 were inadequate.

The NHS Cervical Screening Programme began the introduction of LBC in 2003, following a recommendation from the National Institute of health and Clinical Excellence (NICE).

By August 2006, LBC had been introduced at over half of laboratories responsible for analysing cervical screening samples. National coverage is on track to be completed by 2008.

Julietta Patnick, director of the NHS Cancer Screening Programmes, said: "These figures are extremely encouraging as they show that women are already benefiting from the new LBC technology.

"Not only is the number of inadequate tests falling, reducing anxiety and the number of repeat tests required, but women are also getting their results faster.

"Almost a third of women - 32% - are now receiving their results within four weeks."

Target not reached

For women with moderate or severe cell changes , 71% were referred within four weeks compared with 68% in 2004-05.

In total 3.36 million women were screened during 2005-2006, an increase of 2.4% on the previous year's figure of 3.28 million.

This rise can be attributed to the fact that the number of women within the target 24 to 65 age group is increasing.

However, coverage has actually dropped to 79.5%, a drop of 0.8% on the previous year and 0.5% below the target.

An LBC sample is collected in a similar way to the traditional pap smear, however rather than smearing the sample onto a microscope slide, a brush is used to collect cells and transfer them to preservative fluid.

The sample is sent to the laboratory where it is spun and treated to remove obscuring material, for example mucus or pus, and a random sample of the remaining cells is taken.

A thin layer of the cells is deposited onto a slide. The slide is then examined in the usual way under a microscope by a cytologist.