Withdrawal of a woman from the NHS cervical screening programme will result in stoppage of all invitations being sent to a woman and permanent removal of her name from the prior notification list (PNL) (1).
Following are the categories in which women may be 'ceased' from the programme:
- informed choice
- some women may request to remove her name from the screening register in the following circumstances:
- women who have never had sex with a man - the risk of developing cervical cancer is very low in a woman who is not sexually active (1,5)
- women with a physical disability which will make sample taking a difficult task
- circumcised women
- women with a learning disability
- terminally ill women (2)
- the health care professional should make sure that prior to ceasing from the programme the woman has received sufficient and accurate information, that she has expressed the desire through a written request (Consent to Cervical Screening)
- age
- women 65 years or older with three consecutive negative cytology results (3)
- women over 65 years who have failed to respond to persistent invitation (1)
- women who have had radiotherapy for cervical cancer
- women with 'absence of cervix'
- women with a total hysterectomy
- male to female transsexuals
- congenital absence of cervix (1)
The lead colposcopist may recommend withdrawal from the programme in
- women with severe cervical stenosis usually due to previous surgery with a history of high grade CIN, cervical glandular intraepithelial neoplasia (cGIN) or unexplained high grade cytology in whom neither cervical dilatation nor hysterectomy is appropriate
- if the women agrees to withdraw she can be ceased from the programme and if she declines to withdraw, cervical screening should be continued (3)
Reference:
- 1. NHS Cancer Screening Programmes 2004. Ceasing women from the NHS cervical screening programme
- 2. NHS Cancer Screening Programmes 2006. Taking samples for cervical screening. A resource pack for trainers
- 3. NHS Cancer Screening Programmes 2010. Colposcopy and programme management. Guidelines for the NHS cervical screening programme 2nd edition.