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Supporting patients to make informed decisions

This page is aimed at primary care staff, including sample takers and reception staff. It may also be useful for other healthcare professionals.

Cervical screening is one of the best ways to prevent cervical cancer, but it is not a mandatory test. You can provide the information and support your patients need to make an informed decision about cervical screening. 

Is cervical screening a choice?

Yes. It is up to the patient to decide whether they want to attend cervical screening.

It’s important that any decision a patient makes is informed. This means that they have all of the information they need to make a decision. The information should be unbiased and factual – not swayed towards either the positive or negative.

How you can support patients to make an informed decision

Ensure patients know both benefits and risks of cervical screening

Benefits:

  • Cervical screening prevents about 7 in 10 (70%) deaths from cervical cancer.
  • Cervical screening can prevent the need for major and, in some cases, life-changing treatment. The test is designed to pick up HPV and cervical cell changes (abnormal cells) early, before cervical cancer develops, so they can be monitored or treated conservatively.

Risks:

  • Cervical screening is uncomfortable or painful for some patients.
  • No test is perfect and, in a few cases, HPV primary screening may give a false positive or negative result. This happens in less than 1 in 10 (about 5%) results. 
  • False results mean there is a small chance of overtreatment for cervical cell changes or unnecessary appointments.  

Ensure the patient has access to accessible information

Patients may need information in a particular format or language in order to fully understand cervical screening and make an informed decision. You can assist them by offering:

Explain what will happen during a test

If you are taking the sample, you should explain to a patient exactly what will happen during the appointment. You should be able to answer questions and respond to concerns. Even if a patient has had cervical screening for many years, it is important not to make assumptions about what they know or how they feel. 

Make it a continual choice

Some women and people with a cervix feel very anxious about screening, so it’s important for all patients to know that they are in control. They can choose to stop the test at any point before or during the appointment. 

Explaining this clearly to them can help them feel empowered and less anxious. It is good practice to continually check in and get their consent by explaining what you will do at each stage, before you do it. For example, you could say, ‘I’m going to insert the speculum now. Is that OK?’, and wait for them to confirm before you do it. 

Respect the patient’s decision 

If the patient withdraws their consent before or during the appointment, let them know they can ask to come back at any time. We have heard of some patients being refused other health services if they do not want cervical screening – this should never be the case. 

If a patient is unsure of having cervical screening at an initial appointment, you can ask them what you could do to support them in future and make sure you signpost them onto support. 

Signposting to further information and support

It is important that patients have access to information and support from other reliable sources. You could signpost them to:

Patients may feel more able to ask difficult questions of or disclose personal experiences to independent organisations, rather than their healthcare professionals, so you can also signpost them to the Jo’s Cervical Cancer Trust Helpline on 0808 802 8000

Patients who withdraw from cervical screening

Patients can choose to withdraw from the Cervical Screening Programme (CSP). It is important patients understand:

  • the risks and benefits of having or not having cervical screening
  • that they will no longer receive invitations for cervical screening
  • that they can ask to return to the CSP if they choose.

The patient should put their decision to withdraw in writing. It is the GP surgery’s responsibility to notify the CSP. 

Useful resources

  • Marlow, L. et al (2019). Barriers to cervical screening among older women from hard-to-reach groups: a qualitative study in England. BMC Women’s Health. 19;38. pp.2-10.
  • Landy, R. et al (2016). Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case-control study. BJC. 115;9. pp.1140-1146.
  • Mayrand, M. et al (2007). Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer. The New England Journal of Medicine. 357. pp.1579-1588.
  • Raffle, A. et al (2003). Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical abnormality and modelling of cases and deaths prevented. BMJ. 326;7395. pp.1-5.
  • Marteau, T. et al (2001). A measure of informed choice. Health Expectations. 4;2. pp.99-108.

August 2023 - Please be aware that this information for health professionals is currently undergoing regular review in line with our editorial policy. However the information remains valid.

Good practice guidance >

Read our good practice guidance for before, during and after cervical screening.

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Date last updated: 
12 Nov 2020
Date due for review: 
01 Nov 2023
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