By: 16 December 2021
Decrease in number of people having cervical screening tests in 2020-21, new statistics show

Latest annual figures on cervical screening show the number of individuals being tested fell slightly in 2020-21 compared to the previous year.

Cervical Screening Programme, England 2020-21, which is published today by NHS Digital, presents information on individuals aged 25-64 who were invited for regular screening [1].

The publication includes the numbers invited for screening, the number of tests on screening samples sent to pathology laboratories, the results of the samples taken and the time taken to return results. It also shows the change in the cervical screening programme’s coverage in England compared to previous years.

Disruption from coronavirus (COVID-19) is not thought to have significantly affected the quality of the data submitted for 2020-21, however it is likely to have had an effect on activity [2]. These statistics should therefore be interpreted with care.

In 2020-21, 4.59m individuals were invited for screening – a 1.0% decrease on 2019-20, when the figure was 4.63m.

The number of tests carried out also fell. A total of 3.03m individuals aged 25 to 64 were tested – a decrease of 5.3% compared to the previous year, when 3.20m were tested.

In 2020-21, 70.2% of eligible individuals aged 25 to 64 had last been screened within the required number of years. This represents a drop in coverage of 2.0 percentage points from the previous year, when coverage was 72.2%.

At 31 March 2021, coverage was lower in the 25 to 49 age group – it decreased to 68.0%, from 70.2% in 2020.

In the 50 to 64 age group, coverage decreased to 74.7% in 2021 from 76.1% in 2020.

Across both age ranges, regional coverage varied from 64.7% in London to 75.5% in the North East. All screening regions reported a decrease compared with 2020.

No local authorities reached 80% coverage, while 91 out of 149 had coverage levels of 70% and above, a decrease of 12 compared to 2020.

Coverage ranged from 45.8% in Kensington and Chelsea (London) to 78.4% in Derbyshire (East Midlands).

The report also shows the number of individuals referred for colposcopy, a procedure to look at the cervix.

Human Papilloma Virus (HPV) primary screening was fully implemented in December 2019, which means that a sample is first tested for HPV and where the test result is positive, a cytology screen is then performed[3]. Those who have a HPV positive screen with an abnormal cytology result are referred to colposcopy.

In 2020-21, there were 176,561 referrals to colposcopy, compared to 191,563 in 2019-20.


Read the full report

Cervical Screening Programme, England – 2020-21



  1. National policy is that eligible individuals are offered screening every three or five years depending on their age. Individuals between the ages of 25 and 64 are invited for regular cervical screening under the NHS Cervical Screening Programme. Coverage is defined as the percentage of individuals eligible for screening at a given point in time who were screened adequately within a specified period (within 3.5 years for those aged 25 to 49, and within 5.5 years for those aged 50 to 64).
  2.  Due to coronavirus measures, attendance for screening was less than usual in the early part of 2020-21. Screening and referral of those individuals considered to be at highest risk of a significant cervical abnormality was prioritised during this period and continued to take place. From the summer of 2020, screening services were fully restored and higher than normal levels of screening tests were seen. All individuals eligible for screening who should have received an invitation in 2020-21 were invited.
  3. An inadequate sample result can be assigned following a test outcome of either HPV unavailable or cytology inadequate. Individuals who have an inadequate sample are either tested again or referred to colposcopy. In 2020-21, 0.4% of all samples were inadequate, a decrease from 1.2% in 2019-20 and 2.3% in 2018-19. The reduction in inadequate samples in 2020-21 is related to the implementation of HPV primary screening. Under HPV primary screening, a HPV negative result means cytology is not required. Therefore cytology tests, which have a higher rate of inadequate results, are used less often.