Cervical cancer screening recall scenarios

Note: Clinicians should refer to the Clinical Guidelines for Cervical Cancer Screening and any documentation, letters or alerts from the National Screening Register for information about recall intervals and add the planned recalls for treatment such as referrals or tests.

Tip: Links to the relevant guidelines are listed at the top of the Test;result;cervical screening clinical item.

Scenario A - No recall protocol

Some health services may elect not to have a recall protocol for Cervical Cancer Screening.

Patients over 25 or in high-risk groups are assessed on presentation and tests requested as required. GP Review of Clinical Software does not recommend this approach.

Scenario B - Initial recall only

Use an on registration recall that triggers the first recall at age 25 years but before 74 years. As patients present, the next recall is manually added after results are received and interpreted.

Add a recall to File > Reference Tables > Automated Recall Types using the following values.

Table 1. Cervical cancer screening recall - initial on registration recall only
Property	Values for On Registration
Example
Recall for	`Test;cervical screening`
Sex	`Female`
Min Age	blank
Max Age	`74 years`
Age	`25 years`

Scenario C - Simple cycle

This is an initial recall at age 25 years but before 74 years followed by five-yearly recalls. In this case the completion of the recall is normally done after the result is known, so that the interval can be accepted or adjusted.

Add two recalls to File > Reference Tables > Automated Recall Types using the following values.

Note: The completion of the Test;result;cervical screening or Results;cervical screening, high risk patient clinical guidelines or letters and notifications from the NCSR are not factored into this recall option. Clinicians should manually adjust the recall date as required.

Table 2. Cervical cancer screening recall - simple cycle
Property	Values for On Registration	Values for On Completion Trigger
Example
Recall for	`Test;cervical screening`	`Test;cervical screening`
Sex	`Female`	`Female`
Min Age	blank	blank
Max Age	`74 years`	`74 years`
Age	`25 years`	-
Trigger on completion/presentation of for Single clinical item	-	`Test;cervical screening`
Offset	-	`5 years`

Scenario D - Cycle including results

This is an initial recall at age 25 years but before 74 years which triggers a recall to record the results. At this stage completion of the results triggers the next recall for cervical screening and the interval can be adjusted as required.

Add three recalls to File > Reference Tables > Automated Recall Types using the following values.

Note: Consider abnormal results when determining the On Completion recall for the next test.

The qualifier results of the cervical cancer screening, high risk patient clinical guidelines or letters and notifications from the NCSR are not factored into this recall option. Clinicians should manually adjust the recall date as required.

Table 3. Cervical cancer screening recall - cycle including results
Property	Values for On Registration	Values for On Completion Trigger 1	Values for On Completion Trigger 2
Example
Recall for	`Test;cervical screening`	`Test;result; cervical screening` or `Results;cervical screening`	`Test;cervical screening`
Sex	`Female`	`Female`	`Female`
Min Age	blank	blank	blank
Max Age	`74 years`	blank	`74 years`
Age	`25 years`	-	-
Trigger on completion/presentation of for Single clinical item	-	`Test;cervical screening`	`Test;result; cervical screening` or `Results;cervical screening`
Offset	-	`0 days`	`5 years`

Scenario E - Qualifier-driven cycle

This is an initial recall at age 25 years but before 74 years which triggers a recall to record the results. When the results are recorded, it is a qualifier that triggers the next recall.

To implement this recall scenario:

In File > Reference Tables > Automated Recall Types, add the On Registration recall from Table 4.
Also add the On Completion Trigger recall listed in Table 4.
Add the On Qualifier recalls for different results described in Table 5.

Note: Where a patient has an abnormal result and is recalled for a follow up, no automatic recalls are suggested for next steps because of the complexity of cervical recall process flows. Clinicians should manually add a recall for the appropriate treatment, such as Colposcopy, referral, retest. Letters and notifications from the NCSR including suggested actions need to be manually actioned by clinicians.

Where the manual action includes adding a recall for Test;cervical screening, any automated recalls continue to function as expected.

Table 4. Cervical cancer screening recall - qualifier-driven cycle - on completion recalls
Property	Values for On Registration	Values for On Completion Trigger
Example
Recall for	`Test;cervical screening`	`Test;result; cervical screening` or `Results;cervical screening`
Sex	`Female`	`Female`
Min Age	blank	blank
Max Age	`74 years`	blank
Age	`25 years`	-
Trigger on completion/presentation of for Single clinical item	-	`Test;cervical screening`
Offset	-	`0 days`

Table 5. Cervical cancer screening recall - qualifier-driven cycle - on qualifier recalls
Property	Values for On Qualifier 1	Values for On Qualifier 2	Values for On Qualifier 3	Values for On Qualifier 4
Example
Recall for	`Test;cervical screening` (or site equivalent)	`Followup;cervical screening; abnormal`	`Followup;cervical screening; abnormal`	`Followup;cervical screening; abnormal`
Qualifier	`Cervical screening management`	`Cervical screening management`	`Cervical screening management`	`Cervical screening management`
Trigger for	`CST in 5 years`	`Follow up of abnormality`	`Unsatisfactory - HPV test now`	`Unsatisfactory - LBC now`
Sex	`Female`	`Female`	`Female`	`Female`
Min Age	blank	blank	blank	blank
Max Age	`74 years`	blank	blank	blank
Age	`-`	-	-	-
Offset	`5 years`	`0 Days`	`0 Days`	`0 Days`