NHS Information Authority

Data Standards Programme

Changes to KC53 will allow screening services to develop a better understanding of the needs of the eligible population (especially at a local level), facilitate quality assurance, highlight areas where non-standard practices are being followed and allow more accurate calculations of coverage.

SCREENING TEST

Attributes of this Class are:

K		TEST NUMBER
	O	BREAST CANCER SCREENING TEST OUTCOME
		breast screening only
	O	CYTOLOGY RESULT TYPE
	O	CYTOLOGY SCREENING ACTION TYPE
		LOCATION TYPE
	O	NON ROUTINE RECALL INTERVAL
		OPPORTUNISTIC SCREENING INDICATOR
		cervical screening only
	O	OPPORTUNISTIC SCREENING TYPE
	O	PATHOLOGY RESULT REPORTED DATE
	O	RESULT SENT DIRECT
		cervical cytology only
		SCREENED WHILE SUSPENDED INDICATOR
		cervical screening only
	O	SCREENING RESULT DATE
		SCREENING TEST DATE
	O	SCREENING TEST RESULT

OPPORTUNISTIC SCREENING INDICATOR

OPPORTUNISTIC SCREENING INDICATOR

OPPORTUNISTIC SCREENING TYPE

OPPORTUNISTIC SCREENING INDICATOR

An indicator that the SCREENING TEST has been carried out opportunistically, i.e. not as a result of a SCREENING TEST INVITATION. The type of opportunistic screening that has led to a SCREENING TEST being carried out opportunistically, i.e. not as a result of a SCREENING TEST INVITATION.

Classification:

a.	Yes
a.	Screened while recall suspended
b.	No
b.	Screened while recall ceased
c.	Not invited by programme

This attribute is also known by these names:

Context	Alias
plural	OPPORTUNISTIC SCREENING INDICATORS
plural	OPPORTUNISTIC SCREENING TYPES

RESULT SENT DIRECT

An indicator of whether the cervical cytology result letter is sent directly to the PATIENT by the HEALTH AUTHORITY. An indicator of whether the cervical cytology result letter is sent directly to the PATIENT by the call and recall service.

Classification:

a.	Yes
b.	No

This attribute is also known by these names:

Context	Alias
plural	RESULT SENT DIRECTS
plural	RESULTS SENT DIRECT

SCREENED WHILE SUSPENDED INDICATOR

SCREENING RESULT SENT DATE

The date on which the result of a cervical smear is sent from the PRIMARY CARE TRUST. The date on which the result of a cervical smear is sent from the call and recall service.

This attribute is also known by these names:

Context	Alias
plural	SCREENING RESULT SENT DATES

KC53 1

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Contextual Overview

1. The Department, NHS Cervical Screening Programme (NHSCSP) and Regional Offices require information from HEALTH AUTHORITIES on Cervical Screening.

1. The Department, NHS Cervical Screening Programme (NHSCSP) and STRATEGIC HEALTH AUTHORITIES require information from PRIMARY CARE TRUSTS on Cervical Screening.

2. The information helps to monitor the process of achieving the Government's target to reduce the incidence of invasive cervical cancer and to ensure that the screening programme is managed effectively. It is used to monitor coverage by the cervical screening programme of the eligible resident population within Health Authorities.

2. The information helps to monitor the process of achieving the Government's target to reduce the incidence of invasive cervical cancer and to ensure that the screening programme is managed effectively. It is used to monitor coverage by the cervical screening programme of the eligible Primary Care Trust responsible population.

3. Information on the return is also used in Public Expenditure Survey (PES) negotiations, resource allocation to the NHS and Departmental accountability.

4. Information based on the KC53 return is published annually by the Department in the Statistical Bulletin `Cervical Screening Programme'.

Completing Return KC53: Cervical Screening Programme

5. The Cervical SCREENING PROGRAMME is a STRUCTURED PROGRAMME planned by a HEALTH AUTHORITY. The services provided to the population under this programme may be carried out by one or more HEALTH CARE PROVIDERS - NHS trust, General Medical Practitioner (GMP), private or voluntary organisation or any combination of these.

5. The Cervical SCREENING PROGRAMME is a STRUCTURED PROGRAMME planned by a PRIMARY CARE TRUST. The services provided to the population under this programme may be carried out by one or more HEALTH CARE PROVIDERS - NHS trust, General Medical Practitioner (GMP), private or voluntary organisation or any combination of these.

6. Information on Cervical Screening should be readily available from the HEALTH AUTHORITY'S computerised call and recall system. A standard computer programme is provided by the NHS Information Authority.

6. Information on Cervical Screening should be readily available from the call and recall service's computerised call and recall system. A standard computer programme is provided by the NHS Information Authority.

7. The return requires the ORGANISATION CODE and ORGANISATION NAME of the HEALTH AUTHORITY. It requires information about women (PERSONS) resident in the HEALTH AUTHORITY at 31 March. It is completed annually and submitted within two months of this date.

7. The return requires the ORGANISATION CODE and ORGANISATION NAME of the PRIMARY CARE TRUST. It requires information about women (PERSONS) on the lists of GPs in the PRIMARY CARE TRUST and women from the unregistered population who live in the geographical area for which the PRIMARY CARE TRUST is responsible at 31 March. It is completed annually and submitted within two months of this date.

KC53 2

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part A: Cervical Screening Programme - Status of Health Authority Relevant Population

Part A: Cervical Screening Programme - Status of PCT Responsible Population

Part A1

1. Part A1 of KC53 requires information on the routine recall interval in force in the Health Authority for the SCREENING PROGRAMME. This is the CERVICAL SCREENING RECALL INTERVAL.

1. Part A1 of KC53 requires information on the routine recall interval in force in the Primary Care Trust for the SCREENING PROGRAMME. This is the CERVICAL SCREENING RECALL INTERVAL.

Part A2

2. Part A2 of KC53 requires information on the SCREENING STATUS of the SCREENING POPULATION - the number of women resident in the HEALTH AUTHORITIES at 31 March.

2. Part A2 of KC53 requires information on the SCREENING STATUS of the SCREENING POPULATION - the number of women in PRIMARY CARE TRUST'S responsible population at 31 March.

Age of woman at 31 March (column 1)

3. The age bands are derived from the BIRTH DATE of the PERSON.

Under 20 (line 0001)
20-24 (line 0002)
25-29 (line 0003)
30-34 (line 0004)
35-39 (line 0005)
40-44 (line 0006)
45-49 (line 0007)
50-54 (line 0008)
55-59 (line 0009)
60-64 (line 0010)
65-69 (line 0011)
70-74 (line 0012)
75-79 (line 0013)
80 & over (line 0014)




Number of women resident in the Health Authority relevant population (column 2)

Number of women resident in Primary Care Trust responsible population (column 2)

4. This is the total number of women of all ages derived from the registers maintained by the Health Authority to ensure compatibility with the other data recorded on the return.

The relevant population includes:

• all PATIENTS resident within the HEALTH AUTHORITY boundary;

and

• all PATIENTS registered with GPs who form part of PRIMARY CARE GROUPS or PRIMARY CARE TRUSTS for which the HEALTH AUTHORITIES is responsible, but who are resident elsewhere.

4. This is the total number of women of all ages derived from the registers maintained by the Primary Care Trust to ensure compatibility with the other data recorded on the return.

   The responsible population includes:

   • all PATIENTS on the lists of the GPs in the PRIMARY CARE TRUST;

   and

   • the unregistered population who live within the geographical area for which the PRIMARY CARE TRUST is responsible.

The relevant population does not include residents registered with GPs who form part of PRIMARY CARE GROUPSS or PRIMARY CARE TRUSTS responsible to another HEALTH AUTHORITIES.

Number of women recorded as having recall ceased (columns 3, 4 and 5)

5. These columns do not include women with the SCREENING STATUS classification of Recall suspended.

6. Column 3 counts women in the SCREENING PROGRAMME with the SCREENING STATUS classification of Recall ceased - clinical reasons. Women no longer eligible for screening due to removal of the cervix are included.

7. Column 4 counts the number of women with the SCREENING STATUS classification of Recall ceased - age reasons, and column 5 counts those with the classification of Recall ceased - other reasons.

Eligible population (column 6)

8. This is calculated by subtracting the number of women in column 3 (i.e. women with the SCREENING STATUS of Recall ceased - clinical reasons) from the number in column 2 (i.e. the HEALTH AUTHORITIES relevant population).

8. This is calculated by subtracting the number of women in column 3 (i.e. women with the SCREENING STATUS of Recall ceased - clinical reasons) from the number in column 2 (i.e. the PRIMARY CARE TRUST responsible population).

Number of women whose most recent test was no more than 5 years ago (column 7)

9. This is calculated from the addition of columns (2) to (5) in part A3.

Coverage (%) - less than 5 years since last adequate test (column 8)

10. This is calculated from columns (6) and (7) in Part A2.

Target Age Group (25-64) (line 0015)

11. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

Total all ages (line 9999)

12. This is the total for all age groups counted in lines 0001 to 0014 for each category of women.

KC53 3

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part A3: Cervical Screening Programme - Number of Women Screened by Time since Last Test

Part A3: Cervical Screening Programme - Screening Status of Eligible Women at 31 March YYYY

1. This part of the return collects information specifically about the number of women screened by time since their last test. It includes all women who have had a SCREENING TEST at any time during their life, even if the test was not part of a call and recall system, but was taken opportunistically. It does not include inadequate tests.

Age of women at 31 March (column 1)

2. The age bands are derived from the BIRTH DATE of the PERSON.

Under 20 (line 0001)
20-24 (line 0002)
25-29 (line 0003)
30-34 (line 0004)
35-39 (line 0005)
40-44 (line 0006)
45-49 (line 0007)
50-54 (line 0008)
55-59 (line 0009)
60-64 (line 0010)
65-69 (line 0011)
70-74 (line 0012)
75-79 (line 0013)
80 & over (line 0014)

Number of women last tested in the last 3 years (column 2)

Number of women last tested more than 3 years ago, but not more than 5 years ago (column 3)

Number of women last tested more than 5 years ago, but not more than 10 years ago (column 4)

Number of women last tested more than 10 years ago, but not more than 15 years ago (column 5)

Number of women last tested more than 15 years ago (column 6)

2. The age bands are derived from the BIRTH DATE of the PERSON.

   Under 20 (line 0001)
   20-24 (line 0002)
   25-29 (line 0003)
   30-34 (line 0004)
   35-39 (line 0005)
   40-44 (line 0006)
   45-49 (line 0007)
   50-54 (line 0008)
   55-59 (line 0009)
   60-64 (line 0010)
   65-69 (line 0011)
   70-74 (line 0012)
   75-79 (line 0013)
   80 & over (line 0014)

Number of women whose most recent adequate test was in last 1.5 years (column 2)

Number of women whose most recent adequate test was more than 1.5 years but no more than 3 years ago (column 3)

Number of women whose most recent adequate test was more than 3 years but no more than 3.5 years ago (column 4)

Number of women whose most recent adequate test was more than 3.5 years but no more than 5 years ago (column 5)

Number of women whose most recent adequate test was more than 5 years but no more than 10 years ago (column 6)

Number of women whose most recent adequate test was more than 10 years but no more than 15 years ago (column 7)

Number of women whose most recent adequate test was more than 15 years ago (column 8)

3. The SCREENING TEST DATE should be used to derive the count of women tested in the time periods required by the return.

Number of women with no cytology record (column 7)

Women called but no adequate smear (column 9)

4. This is a count of women in the HEALTH AUTHORITY relevant population with no cervical screening history.

   The relevant population includes:

   • all PATIENTS resident within the HEALTH AUTHORITY boundary;

   and

   • all PATIENTS registered with GPs who form part of PRIMARY CARE GROUPS or PRIMARY CARE TRUSTS for which the HEALTH AUTHORITY is responsible, but who are resident elsewhere.

   The relevant population does not include residents registered with GPs who form part of PRIMARY CARE GROUPSS or PRIMARY CARE TRUSTSS responsible to another HEALTH AUTHORITY.

   Target Age Group (25-64) (line 0015)

5. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

4. This is a count of the number of women who have been invited at any time in their lives but have no adequate smear.

Women called but never attended (column 10)

5. This is a count of the number of women who have been invited at any time in their lives but have never attended.

Number of women with no cytology record (column 11)

6. This is a count of women in the PRIMARY CARE TRUST responsible population with no cervical screening history.
   
   The responsible population includes:

   • all PATIENTS on the lists of the GPs in the PRIMARY CARE TRUST;

   and

   • the unregistered population who live within the geographical area for which the PRIMARY CARE TRUST is responsible.

Target Age Group (25-64) (line 0015)

7. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

Total all ages (line 9999)

8. This is the total for all age groups counted in lines 0001 to 0014 for each category of women.


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KC53 4

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Change to Central Return Form: Change guidance text

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part B: Cervical Screening Programme - Number of Women Invited

1. Part B of KC53 requires age-banded data on the number of women invited for screening, The number invited relates to SCREENING TEST INVITATIONS with an INVITED FOR SCREENING DATE between 1 April and 31 March. This date does not necessarily relate to a due date in the year - e.g. the SCREENING TEST could be set to take place outside this period. Where a woman is invited on more than one occasion in the year, the last invitation is recorded on KC53.

Age of woman at 31 March (column 1)

2. The age bands are derived from the BIRTH DATE of the PERSON.

Under 20 (line 0001)
20-24 (line 0002)
25-29 (line 0003)
30-34 (line 0004)
35-39 (line 0005)
40-44 (line 0006)
45-49 (line 0007)
50-54 (line 0008)
55-59 (line 0009)
60-64 (line 0010)
65-69 (line 0011)
70-74 (line 0012)
75 & over (line 0013)

Call (column 2)

3. A count of the number of women invited for their first screen i.e. those who have never been screened before. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification First call.

Routine recall (column 3)

4. A count of the number of women invited for screening in the year as a result of a routine recall for screening. These women will have had a previous negative result and been recalled after the usual interval (3 to 5 years). The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Routine recall.

Surveillance (column 4)

5. A count of the number of women invited for early screening because of a previous abnormal screening result or following treatment for cervical abnormalities. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than three years for surveillance.

Abnormality (column 5)

6. A count of the number of women invited for early screening because their last smear showed some abnormality and a repeat was advised. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than three years because of abnormality.

Inadequate smear (column 6)

7. A count of the number of women invited for screening because their last smear was inadequate. The INVITATION TYPE of the SCREENING TEST INVITATION will have either the classification Repeat in less than three years because of inadequate smear, or the classification Technical recall (inadequate test).

Target age group (line 0014)

8. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

8. This counts the number of women in the SCREENING PROGRAMME aged between 20 and 64 on 31 March (sum of lines 0002 to 0010).

Total all ages (line 9999)

9. This is the total for all age groups counted in lines 0001 to 0013 for each INVITATION TYPE.

KC53 5

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part C: Cervical Screening Programme - Number of Women Tested

Part C1: Cervical Screening Programme - Number of Women Tested - by Age

1. Part C of KC53 requires data on the women screened in the year, by invitation or opportunistically. The number screened relates to SCREENING TESTS with a SCREENING TEST DATE between 1 April and 31 March. Where a woman is screened more than once in the year, for whatever reason, her INVITATION TYPE at her last SCREENING TEST DATE is to be recorded.

1. Part C1 of KC53 requires data on the women screened in the year, by invitation or opportunistically. The number screened relates to SCREENING TESTS with a SCREENING TEST DATE between 1 April and 31 March. Where a woman is screened more than once in the year, for whatever reason, her INVITATION TYPE at her first SCREENING TEST DATE in the review period is to be recorded.

Call (column 2)

2. A count of the number of women screened in the year as a result of a first call for screening within 12 months of the original invitation. These women will not have been screened before. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification First call.

Routine recall (column 3)

3. A count of the number of women screened in the year as a result of a routine recall for screening within 12 months of the recall invitation. These women will have had a previous negative result and been recalled after the usual interval (3 to 5 years). The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Routine recall.

Surveillance (column 4)

4. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years for reasons of surveillance.

4. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years for surveillance.

Abnormality (column 5)

5. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. These women will usually have had a recent mildly abnormal smear. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years for reasons of abnormality.

5. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. These women will usually have had a recent mildly abnormal smear. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years because of abnormality.

Inadequate smear (column 6)

6. Enter the number of women screened in the year as a result of a technical recall within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have either the classification Repeat in less than 3 years for reasons of inadequate smear or the classification Technical recall (inadequate test).

6. Enter the number of women screened in the year as a result of a technical recall within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have either the classification Repeat in less than 3 years because of inadequate smear or the classification Technical recall (inadequate test).

While recall suspended (column 7)

7. A count of the number of women screened in the year who were suspended from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the SCREENED WHILE SUSPENDED INDICATOR set.

Opportunistic screen (column 8)

7. A count of the number of women screened in the year who were suspended from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'screened while recall suspended' .

While recall ceased (column 8)

8. A count of the number of women screened opportunistically during the year. This includes all women screened more than 12 months after the issue of any invitation. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING INDICATOR set.

8. A count of the number of women screened opportunistically in the year who were ceased from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'screened while recall ceased'.

Not Invited by Programme (column 9)

9. A count of the number of women screened opportunistically during the year. This includes all women whose Recall Status was "No action", "GP not informed", "GP informed", "ZZZ GP" and those women whose Recall Status was "Final non-responder" where the initial invitation was generated more than 12 months ago. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'not invited by programme'.

Target age group (line 0014)

10. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

Total all ages (line 9999)

10. This counts the number of women in the SCREENING PROGRAMME aged between 20 and 64 on 31 March (sum of lines 0002 to 0010).

Total all women (line 9999)

11. This is the total for all age groups counted in lines 0001 to 0013 for each INVITATION TYPE or women who have had a SCREENING TEST with either the SCREENED WHILE SUSPENDED INDICATOR or OPPORTUNISTIC SCREENING INDICATOR set.

11. This is the total for all age groups counted in lines 0001 to 0013 for each INVITATION TYPE or women who have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE recorded.

KC53 6

KC53 6

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part D: Cervical Screening Programme - Result of Test

1. Part D of KC53 requires age-banded data on the most severe results of cervical screening tests recorded during the year. It does not include inadequate tests. Where a woman has only one smear tested in the year which turns out to be inadequate, or more than one, all of which are inadequate, no entry is required.

2. The data are based on the results of the woman's most severe test in the year and relate to SCREENING TESTS with a SCREENING TEST DATE between 1 April - 31 March. Classifications are those of CYTOLOGY RESULT TYPES of a REQUEST FOR PATHOLOGY INVESTIGATION and are in accordance with the categories shown in box 22 of HMR 101/5 Request/Report for Cervical or Vaginal Cytology.

Negative (column 2)

3. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Negative (cat. 2).

Borderline/Mild dyskaryosis (column 3)

Borderline (column 3)

4. A count of the number of women whose most severe CYTOLOGY RESULT TYPEclassification was Borderline changes (cat. 8) or Mild dyskaryosis (cat. 3).

Moderate dyskaryosis (column 4)

4. A count of the number of women whose most severe CYTOLOGY RESULT TYPE classification was Borderline changes (cat. 8) .

Mild dyskaryosis (column 4)

5. A count of the number of women whose most severe CYTOLOGY RESULT TYPE classification was Mild dyskaryosis (column 4) .

Moderate dyskaryosis (column 5)

6. A count of the number of women whose most severe CYTOLOGY RESULT TYPEclassification was Moderate dyskaryosis (cat. 7).

Severe dyskaryosis (column 5)

Severe dyskaryosis (column 6)

7. A count of the number of women whose most severe CYTOLOGY RESULT TYPEclassification was Severe dyskaryosis (cat. 4) or Severe dyskaryosis/?invasive carcinoma (cat. 5) or ?Glandular neoplasia (cat. 6).

7. A count of the number of women whose most severe CYTOLOGY RESULT TYPE classification was Severe dyskaryosis (cat. 4).

Severe dyskaryosis/?invasive carcinoma (column 7)

8. A count of the number of women whose most severe CYTOLOGY RESULT TYPE classification was Severe dyskaryosis/?invasive carcinoma (cat. 5).

?Glandular neoplasia (column 8)

9. A count of the number of women whose most severe CYTOLOGY RESULT TYPE classification was ?Glandular neoplasia (cat. 6).

Target age group (line 0014)

10. This counts the number of women in the SCREENING PROGRAMME aged between 25 and 64 on 31 March (sum of lines 0003 to 0010). Coverage of the screening programme is based on women aged 25 to 64, and not on the NHS Cervical Screening Programme's target population of women aged 20 to 64 who are eligible to receive screening test invitations.

10. This counts the number of women in the SCREENING PROGRAMME aged between 20 and 64 on 31 March (sum of lines 0002 to 0010).

Total all ages (line 9999)

11. This is the total for all age groups counted in lines 0001 to 0013 for each CYTOLOGY RESULT TYPE.

KC53 6

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part C2: Cervical Screening Programme - Number of Women Tested - by Result

1. Part C2 of KC53 requires data on the women aged 20 - 64 screened in the year, by invitation or opportunistically. The number screened relates to SCREENING TESTS with a SCREENING TEST DATE between 1 April and 31 March. Where a woman is screened more than once in the year, for whatever reason, her INVITATION TYPE at her first SCREENING TEST DATE in the review period is to be recorded.

Call (column 2)

2. A count of the number of women screened in the year as a result of a first call for screening within 12 months of the original invitation. These women will not have been screened before. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification First call.

Routine recall (column 3)

3. A count of the number of women screened in the year as a result of a routine recall for screening within 12 months of the recall invitation. These women will have had a previous negative result and been recalled after the usual interval (3 to 5 years). The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Routine recall.

Surveillance (column 4)

4. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years for surveillance.

Abnormality (column 5)

5. A count of the number of women screened in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. These women will usually have had a recent mildly abnormal smear. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years because of abnormality.

Inadequate smear (column 6)

6. Enter the number of women screened in the year as a result of a technical recall within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have either the classification Repeat in less than 3 years because of inadequate smear or the classification Technical recall (inadequate test).

While recall suspended (column 7)

7. A count of the number of women screened in the year who were suspended from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'screened while recall suspended' .

While recall ceased (column 8)

8. A count of the number of women screened opportunistically in the year who were ceased from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'screened while recall ceased'.

Not Invited by Programme (column 9)

9. A count of the number of women screened opportunistically during the year. This includes all women whose Recall Status was "No action", "GP not informed", "GP informed", "ZZZ GP" and those women whose Recall Status was "Final non-responder" where the initial invitation was generated more than 12 months ago. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'not invited by programme'.

Result of test

10. This is classified by the following CYTOLOGY RESULT TYPE:
    Inadequate (cat. 1) (line 0001)
    Negative (cat. 2) (line 0002)
    Borderline changes (cat. 8) (line 0003)
    Mild dyskaryosis (cat. 3) (line 0004)
    Moderate dyskaryosis (cat. 7) (line 0005)
    Severe dyskaryosis (cat. 4) (line 0006)
    Severe dyskaryosis/?invasive carcinoma (cat. 5) (line 0007)
    ?Glandular neoplasia (cat. 6) line 0008)
    

Total women tested aged 20-64 (line 9999)

11. This counts the number of women in the SCREENING PROGRAMME aged between 20 and 64 on 31 March (sum of lines 0001 to 0008).

KC53 6

KC53 7

KC53 7

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part E: Cervical Screening Programme - Notification of Result - Waiting Times

1. This part of the return requires information on the length of time elapsing between a woman taking a smear test and when notification of the result is sent to her by the HEALTH AUTHORITIES The national standard to be achieved is that women should be advised in writing of the result of their test four weeks from the date the test was taken. The information is used to monitor the performance of SCREENING PROGRAMMES and laboratories.

2. The return also collects information on those instances where the letter is sent directly by the laboratory or by some other agency instead of by the HEALTH AUTHORITY.

3. The return counts all tests and not just those tests with the most severe result. It includes only smears taken as part of a NHS SCREENING PROGRAMME.

Number of weeks between date smear is taken and date result is sent from the Health Authority

4. This is the number of weeks between the SCREENING TEST DATE and the SCREENING RESULT SENT DATE of the SCREENING TEST, where the RESULT SENT DIRECT indicator is Yes.

5. They are sub-divided into the following time periods:

Less than or equal to four weeks (line 0001)
> 4 weeks up to 6 weeks (line 0002)
> 6 weeks up to 8 weeks (line 0003)
> 8 weeks up to 10 weeks (line 0004)
> 10 weeks up to 12 weeks (line 0005)
> Over 12 weeks (line 0006)

Number of tests (column 3)

6. This counts the number of SCREENING TESTS where results were sent from the HEALTH AUTHORITY for each time period.

Total (line 0007)

7. This is the total of SCREENING TESTS for all time periods counted in lines 0001 to 0006.

Letter not sent by Health Authority (line 0008)

8. This counts the number of SCREENING TESTS where the RESULT SENT DIRECT indicator is No, indicating that the result was not sent by the HEALTH AUTHORITY.

KC53 7

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part C3: Cervical Screening Programme - Number of Tests - by Result

1. Part C3 of KC53 requires data on all tests in the review period, not limited to the target age group 20 - 64, by invitation or opportunistically. The number screened relates to SCREENING TESTS with a SCREENING TEST DATE between 1 April and 31 March. Where a woman is screened more than once in the year, for whatever reason, her INVITATION TYPEat her first SCREENING TEST DATE in the review period is to be recorded.

Call (column 2)

2. A count of the number of tests in the year as a result of a first call for screening within 12 months of the original invitation. These women will not have been screened before. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification First call.

Routine recall (column 3)

3. A count of the number of tests in the year as a result of a routine recall for screening within 12 months of the recall invitation. These women will have had a previous negative result and been recalled after the usual interval (3 to 5 years). The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Routine recall.

Surveillance (column 4)

4. A count of the number of tests in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years for surveillance.

Abnormality (column 5)

5. A count of the number of tests in the year as a result of a non-routine recall for screening within 12 months of the recall invitation. These women will usually have had a recent mildly abnormal smear. The INVITATION TYPE of the SCREENING TEST INVITATION will have the classification Repeat in less than 3 years because of abnormality.

Inadequate smear (column 6)

6. Enter the number of tests in the year as a result of a technical recall within 12 months of the recall invitation. The INVITATION TYPE of the SCREENING TEST INVITATION will have either the classification Repeat in less than 3 years because of inadequate smear or the classification Technical recall (inadequate test).

While recall suspended (column 7)

7. A count of the number of tests in the year of women who were suspended from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'Screened while recall suspended' .

While recall ceased (column 8)

8. A count of the number of tests in the year of women who were ceased from the call and recall system at the time of their SCREENING TEST DATE. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'screened while recall ceased'.

Not Invited by Programme (column 9)

9. A count of the number of opportunistic tests during the year. This includes all women whose Recall Status was "No action", "GP not informed", "GP informed", "ZZZ GP" and those women whose Recall Status was "Final non-responder" where the initial invitation was generated more than 12 months ago. These women will have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE 'not invited by programme'.

Result of test

10. This is classified by the following CYTOLOGY RESULT TYPES:
    Inadequate (cat. 1) (line 0001)
    Negative (cat. 2) (line 0002)
    Borderline changes (cat. 8) (line 0003)
    Mild dyskaryosis (cat. 3) (line 0004)
    Moderate dyskaryosis (cat. 7) (line 0005)
    Severe dyskaryosis (cat. 4) (line 0006)
    Severe dyskaryosis/?invasive carcinoma (cat. 5) (line 0007)
    ?Glandular neoplasia (cat. 6) line 0008)
    

Total all results (line 9999)

11. This counts the number of tests in the SCREENING PROGRAMME for all age groups on 31 March (sum of lines 0001 to 0008).

KC53 7

KC53 8

KC53 8

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

Part F: Cervical Screening Programme - Test Recall/Status of women following most severe screening result in the year

1. This part of the return collects information about the action taken following a woman's most severe test result in a year.

2. The women included are those who have had a SCREENING TEST and are aged 20 to 64. The age is derived from the BIRTH DATE of the PERSON.

3. The data are based on the results of the woman's most severe test in the year and relate to SCREENING TESTS with a SCREENING TEST DATE between 1 April - 31 March. Classifications are those of CYTOLOGY RESULT TYPES of a REQUEST FOR PATHOLOGY INVESTIGATION and are in accordance with the categories shown in box 22 of HMR 101/5 Request/Report for Cervical or Vaginal Cytology.

3. The data are based on the results of the woman's most severe test in the year and relate to SCREENING TESTS with a SCREENING TEST DATE between 1 April - 31 March. Classifications are those of CYTOLOGY RESULT TYPES of a REQUEST FOR PATHOLOGY INVESTIGATION and are in accordance with the categories shown in box 22 of HMR 101/5 Request/Report for Cervical or Vaginal Cytology.

Woman's most severe test result in the year

4. This is classified by the following CYTOLOGY RESULT TYPES:

Inadequate (cat. 1)
Negative (cat. 2)
Mild dyskaryosis (cat. 3)
Severe dyskaryosis (cat. 4)
Severe dyskaryosis/?invasive carcinoma (cat. 5)
?Glandular neoplasia (cat. 6)
Moderate dyskaryosis (cat. 7)
Borderline changes (cat. 8)

5. The return requires a count of the CYTOLOGY SCREENING ACTION TYPE against each CYTOLOGY RESULT TYPE. The actions are classified into:

5. The return requires a count of the CYTOLOGY SCREENING ACTION TYPE against each CYTOLOGY RESULT TYPE. The actions are classified into:

Normal (A) -	Standard Health Authority recall interval (Normal) (A)
Normal (A) -	Standard Primary Care Trust recall interval (Normal) (A)
Suspend (S) -	Refer for medical assessment or under medical treatment (Suspend) (S)
Repeat (R) -	Repeat at interval specified (R)

6. The actions are based on result codes 1 to 8 from HMR 101/5, the operational document used by most laboratories for coding the results of cervical smears.

KC53 8

KC65 2

Central Return Form Guidance

KC65 - Colposcopy Clinics: Referrals, Treatments and Outcomes

Part A - Women referred to colposcopy by referral indication and result of referral

1. Part A of the KC65 return is a count of the number of women referred for colposcopy. This information is used to monitor referral patterns to ensure that guidelines on referral are being followed.

2. A colposcopy is a PATIENT PROCEDURE carried out during a CLINIC ATTENDANCE CONSULTANT on a PATIENT. The PATIENT will have been referred to the Colposcopy Clinic:

   -	following a SCREENING TEST carried out either as part of a SCREENING PROGRAMME or opportunistically.
   or
   -	as a result of clinical indication

   In cases where there is both a clinical indication and a SCREENING TEST referral smear, the referral should be treated as clinical indication.

3. The data is based on the woman's first OUT-PATIENT APPOINTMENT CONSULTANT in the quarter regardless of whether she attended the clinic or not.

   Please note that the total number referred as recorded in Part A should equal the total number waiting as recorded in Part B as both parts relate to the same cohort of women.

2. A colposcopy is a PATIENT PROCEDURE carried out during a CLINIC ATTENDANCE CONSULTANT on a PATIENT. The PATIENT will have been referred to the Colposcopy Clinic:

   -	following a SCREENING TEST carried out either as part of a SCREENING PROGRAMME or opportunistically.
   or
   -	as a result of clinical indication

   In cases where there is both a clinical indication and a SCREENING TEST referral smear, the referral should be treated as clinical indication.

3. The data is based on the woman's first OUT-PATIENT APPOINTMENT CONSULTANT in the quarter regardless of whether she attended the clinic or not.

   Please note that the total number referred as recorded in Part A should equal the total number waiting as recorded in Part B as both parts relate to the same cohort of women.

Referral Indication - Screening smear (line 0001)

4. This line counts all the women with a REFERRAL REQUEST for coloposcopy with a COLPOSCOPY REFERRAL INDICATION of Screening smear. These are PERSONS IN A SCREENING PROGRAMME who have been given a SCREENING TEST as part of a planned SCREENING PROGRAMME. It also includes women screened opportunistically, these women have had a SCREENING TEST with the OPPORTUNISTIC SCREENING INDICATOR of Yes.

   In addition, if a PERSON IN A SCREENING PROGRAMME has been suspended from the SCREENING PROGRAMME following colposcopy and is currently having surveillance smears as indicated by SCREENED WHILE SUSPENDED INDICATOR of Yes, it may be that an abnormal smear will cause the woman to be re-referred to colposcopy. In this case the COLPOSCOPY REFERRAL INDICATION should be Screening smear, regardless of whether or not she has been discharged from colposcopy at this time.

4. This line counts all the women with a REFERRAL REQUEST for coloposcopy with a COLPOSCOPY REFERRAL INDICATION of Screening smear. These are PERSONS IN A SCREENING PROGRAMME who have been given a SCREENING TEST as part of a planned SCREENING PROGRAMME. It also includes women screened opportunistically, these women have had a SCREENING TEST with the OPPORTUNISTIC SCREENING TYPE recorded.

   In addition, if a PERSON IN A SCREENING PROGRAMME has been suspended from the SCREENING PROGRAMME following colposcopy and is currently having surveillance smears as indicated by OPPORTUNISTIC SCREENING TYPE of Screened while recall suspended, it may be that an abnormal smear will cause the woman to be re-referred to colposcopy. In this case the COLPOSCOPY REFERRAL INDICATION should be Screening smear, regardless of whether or not she has been discharged from colposcopy at this time.

Referral Indication - Clinical indication (line 0002)

5. This line counts all the women with a REFERRAL REQUEST for coloposcopy with a COLPOSCOPY REFERRAL INDICATION of Clinical indication.

   Where a woman is referred with symptoms and is given a SCREENING TEST the COLPOSCOPY REFERRAL INDICATION should still be Clinical indication and not Screening smear. Where no symptoms are present the COLPOSCOPY REFERRAL INDICATION should not be Clinical indication.

   Results of referral smear

6. The information in columns 2-9 is based on the cervical screening test results, which led to the REFERRAL REQUEST. Classifications are those of CYTOLOGY RESULT TYPES of a REQUEST FOR PATHOLOGY INVESTIGATION and are in accordance with the categories shown in box 22 of HMR 101/5 Request/Report for Cervical or Vaginal Cytology.

   Entries recorded in Other (column 9) should only occur in exceptional circumstances. NHS Cervical Screening Programme (NHSCSP) guidelines state that all smears should be identified as belonging to one of the eight recognised category classifications of CYTOLOGY RESULT TYPE. Other (column 9) does not correspond to these recognised categories and should be used to record those rare cases in which a recognised category is not appropriate. Where an entry is present in Other (column 9) then supporting notes should be recorded in the available box on the first page of the KC65 form.

   Where the cervical screening test results which led to the REFERRAL REQUEST indicates more than one result type, the most severe result should recorded as the CYTOLOGY RESULT TYPE.

5. This line counts all the women with a REFERRAL REQUEST for coloposcopy with a COLPOSCOPY REFERRAL INDICATION of Clinical indication.

   Where a woman is referred with symptoms and is given a SCREENING TEST the COLPOSCOPY REFERRAL INDICATION should still be Clinical indication and not Screening smear. Where no symptoms are present the COLPOSCOPY REFERRAL INDICATION should not be Clinical indication.

Results of referral smear

6. The information in columns 2-9 is based on the cervical screening test results, which led to the REFERRAL REQUEST. Classifications are those of CYTOLOGY RESULT TYPES of a REQUEST FOR PATHOLOGY INVESTIGATION and are in accordance with the categories shown in box 22 of HMR 101/5 Request/Report for Cervical or Vaginal Cytology.

   Entries recorded in Other (column 9) should only occur in exceptional circumstances. NHS Cervical Screening Programme (NHSCSP) guidelines state that all smears should be identified as belonging to one of the eight recognised category classifications of CYTOLOGY RESULT TYPE. Other (column 9) does not correspond to these recognised categories and should be used to record those rare cases in which a recognised category is not appropriate. Where an entry is present in Other (column 9) then supporting notes should be recorded in the available box on the first page of the KC65 form.

   Where the cervical screening test results which led to the REFERRAL REQUEST indicates more than one result type, the most severe result should recorded as the CYTOLOGY RESULT TYPE.

Inadequate (column 2)

7. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Inadequate sample (cat.1).

   NHS Cervical Screening Programme guidelines state the recording of three cervical screening tests with a CYTOLOGY RESULT TYPEclassification of Inadequate sample (cat.1) indicates referral to colposcopy however, referral to colposcopy may occur following an inadequate smear for other reasons.

Borderline changes (column 3)

8. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Borderline changes (cat.8).

   NHS Cervical Screening Programme guidelines state the recording of three cervical screening tests with a CYTOLOGY RESULT TYPEclassification of Borderline changes (cat.8) indicates referral to colposcopy however, referral to colposcopy may occur following a borderline smear for other reasons.

   Mild dyskaryosis (column 4)

9. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Mild dyskaryosis (cat.3).

8. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Borderline changes (cat.8).

   NHS Cervical Screening Programme guidelines state the recording of three cervical screening tests with a CYTOLOGY RESULT TYPEclassification of Borderline changes (cat.8) indicates referral to colposcopy however, referral to colposcopy may occur following a borderline smear for other reasons.

Mild dyskaryosis (column 4)

9. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Mild dyskaryosis (cat.3).

Moderate dyskaryosis (column 5)

10. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Moderate dyskaryosis (cat. 7), including abnormal, unclassifiable and ungraded smears.

Severe dyskaryosis (column 6)

11. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Severe dyskaryosis (cat.4).

Severe dyskaryosis/invasive carcinoma (column 7)

12. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Severe dyskaryosis/?invasive carcinoma (cat.5).

Glandular neoplasia (column 8)

13. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of ?Glandular neoplasia (cat.6), including adenocarcinoma.

Other (column 9)

14. A count of the number of women with a CYTOLOGY RESULT TYPEclassification of Other.

    This should only be used in the rare situations where usual categorisation is not appropriate. Examples include women with incomplete or missing records and women who have moved from abroad.

    Where an entry is present in Other (column 9) then supporting notes should be recorded in the available box on the first page of the KC65 form.

No referral smear (column 10)

15. A count of the number of women who have been referred to the colposcopy clinic with a REFERRAL REQUEST with a COLPOSCOPY REFERRAL INDICATION of Clinical indication.

Total number referred (column 11)

16. This is the total of women referred for colposcopy, split between with those referred with a COLPOSCOPY REFERRAL INDICATION of Clinical indication and those referred with a COLPOSCOPY REFERRAL INDICATION of Screening smear.

Total (line 0003)

17. This is the total for all women counted in columns 2 to 11.