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Cervical screening

Published on 14 April 2022

What's changed in the Scottish Cervical Screening Programme?

In March 2020, human papillomavirus (HPV) testing replaced cervical cytology (looking at cells under a microscope) as the first line screening test in the Scottish Cervical Screening Programme. Cytology-based tests will still be used for participants who test positive for HPV. This change took place because HPV testing is a more effective way of identifying people at risk of cervical cancer.

The HPV test will be carried out using a sample of cells, which is the same method used in the old test, taken during a cervical screening test, so the cervical screening experience has not changed.

HPV is the main cause of cervical cancer. Most changes in the cells of the cervix are caused by HPV. HPV is very common. Four out of five people in Scotland will have HPV at some point in their lives. As there are usually no symptoms, many people have it for months or years without knowing it. Your body can clear most HPV infections by itself, but about one in 10 infections are harder to get rid of.

HPV implementation also saw Scotland's cytology laboratory service reconfigured from seven cytology labs run by NHS boards to two ‘super labs’ which deliver both HPV and cytology testing. These labs are centrally commissioned by NSD.

How will the cervical screening pathway change as a result of HPV testing?

Testing for HPV is an effective way of identifying those at risk of developing cervical cancer. HPV can go on to cause cell changes which, if left untreated, could lead to cervical cancer in around 10 to 15 years' time. That's why, if no HPV is found, participants will be invited for their next cervical screening appointment in five years' time, regardless of age. This is because evidence has shown their chance of developing cervical cancer in this time is very low.

Cytology-based tests will still be used for participants who test positive for HPV. Their pathway and subsequent follow-up will differ according to the test results but they will be followed up more frequently than participants who test negative for HPV.

For further information take a look at the Health Scotland website for FAQs about the changes.

You can also find more information about HPV pathways on the SCCRS Website (NHS Staff Only): HPV Pathways – SCCRS (