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01 December 2020

Women urged to attend delayed cervical screenings

Having to skip a cervical screening can lead to a seven-fold increased risk of cancer for affected women, researchers warn.

cancer cells

Women who were not able to attend their cervical screening during the first wave of the pandemic could have a seven-fold increased risk of cervical cancer if they had to wait for the next round of cervical screening, compared to women who are screened with only a few months delay.

A study, by the Cancer Prevention Group at King’s, investigating the impact of COVID-19 to cervical screening has been published today in MedRxiv. The study, which was funded by Cancer Research UK and has not yet been peer-reviewed, modelled two scenarios to understand the impact of COVID-19 on cervical screening.

The first scenario saw all women eligible for cervical screening during a 3-5 year cycle – 10.7 million women in England – delay their cervical screening to allow primary care providers to catch up on those missed. In this scenario, for every 100,000 women screened with a 6-month delay, 5.9 extra cervical cancers were estimated. This was a total of 630 women.

The second scenario modelled what would happen if half of women who were due for a cervical screening during 2020 – 1.5 million women – had to skip screening entirely due to the disruption of the pandemic and wait for their next cycle. This could be three years for women aged 25-49 and five years for women aged 50-64. In this scenario, there were 41.5 extra cervical cancers per 100,000 women who had to skip their cervical screening, a seven-fold increased risk compared to scenario one.

The authors concluded that although the number of extra cervical cancers for both scenarios are the same – an additional 630 extra women – the risk to women who had to skip a screening altogether is much higher and could result in an advanced stage cancer diagnosis with a poorer survival prognosis.

The authors assumed the numbers of women screened each year in 2021-2024 will be similar to number in previous years and that the NHS would not have the capacity nor the resources to screen substantially more women than they did prior to the disruption.

Cervical screening has been severely disrupted during the COVID-19 pandemic. In England, invitations for screening were suspended from April 2020. Screening invitations resumed in June and every effort was made to invite also those who may have missed screening.


Our research highlights the importance of women attending screening when they receive an invitation. Attending cervical screening regularly is the best way to prevent cervical cancer. All efforts should be focused on measures that ensure that women feel confident to attend and do not miss an entire screening round on account of the COVID-19 disruption.

Dr Alejandra Castanon from the School of Cancer & Pharmaceutical Sciences

Rachel Orritt, Cancer Research UK’s health information manager, said: “Cervical screening reduces deaths from cervical cancer and provides lasting protection against the disease. While attending is a personal choice, we encourage people to take up their invitations, even if they are delayed. And if you have symptoms, you don’t need to wait for screening. Take control and call your GP.”

Stephen Duffy, Professor of Cancer Screening at Queen Mary University of London, who was not involved in this study said “What I like about this study is that it considered what might be the impact of different approaches to getting back to normal post COVID-19. Perhaps counterintuitively the authors argue that it is better to continue to delay screening for everyone over the next several years than to allow a smaller number of women to miss a whole round of screening.”

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