when is it appropriate for a woman not to have a cervical smear despite being in eligible age group

FREE subscriptions for doctors and students... click here
You have 3 more open access pages.

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)


  • 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.

Last edited 11/2020 and last reviewed 11/2020