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Sign in or register for an accountIn the UK there are approximately nine diagnoses of, and, two deaths from cervical cancer every day. However, cervical cancer is largely preventable and the NHS Cervical Screening Programme (NHSCSP), established in 1989, plays a crucial role in early detection. The screening checks for high-risk human papillomavirus (HPV), the primary cause (99.8%) of cervical cancer. While screening is not 100% sensitive, regular testing significantly reduces the risk of missed abnormalities.
Cervical screening in England is offered to women and people with a cervix aged 25 to 64, with testing intervals guided by national policies. Those aged 25 to 49 are invited every 42 months, whilst those aged 50 to 64 are invited every 66 months. From July 2025, participants aged 25 to 49 who test negative for HPV will have their screening interval extended to five years. There is a national target to screen 80% of those eligible to maximise early detection and intervention. It has been estimated that cervical screening has prevented around 4,500 deaths each year at a cost per life saved of £36,000.
Over 39,100 people registered with a Salford GP between the ages of 25 and 49 were screened for cervical cancer in 2023-24. This meant a coverage of 62.9% of all eligible patients. The coverage rate in 2023-24 in Salford was the tenth lowest in England with only Manchester, Blackburn with Darwen and Liverpool having lower rates in the North West.
Whilst 2023-24 saw the highest number of patients screened in a year the coverage rate has been in gradual decline in Salford since 2009-10 (72.2%). Although England has also declined the rate of decline has been greater in Salford. In 2009-10 the Salford rate was 2.2% below the England rate but by 2023-24 it was 6.8% lower. An extra 2,870 Salford patients would have had to have been screened in 2023-24 in order for the Salford rate to match that of England. In all years between 2009-10 and 2023-24 the Salford rate has been significantly lower than England bar 2019-20 and 2021-22.
Salford’s cervical screening coverage for women aged 25 to 49 has worsened since 2021 and is significantly worse than the national rate.
[Download the chart for 25 to 49 year olds (csv format, 2kb)]
Over 14,800 people registered with a Salford GP between the ages of 50 and 64 were screened for cervical cancer in 2023-24. This meant a coverage of 70.0% of all eligible patients. The coverage rate in 2023-24 in Salford was the eighth lowest in England and seventh lowest in the North West.
Again, although 2023-24 saw the highest number of patients screened in a year the coverage rate has been in gradual decline in Salford since 2010-11 (78.5%). Over the period 2009-10 to 2023-24 the coverage across England has also declined. However, the gap has narrowed, indicating Salford's relative performance has improved slightly compared to the national average. In 2009-10 the Salford rate was 8.0% below the England rate but by 2023-24 it had narrowed slightly and was 6.5% lower. An extra 1,030 Salford patients would have to have been screened during 2023-24 in order for the Salford rate to match that of England. In all years between 2009-10 and 2023-24 the Salford rate has been significantly lower than England bar 2021-22.
Salford’s cervical screening coverage for women aged 50 to 64 has steadily worsened since 2011 and is significantly worse than the national rate.
[Download chart for 50 to 64 year olds (csv format, 2kb)]
Analysis of the data by Primary Care Network (PCN) showed that Broughton (52.9%) and Salford South East (55.9%) had the lowest screening rates in the 25 to 49 age cohort in Salford in 2023-24, and have consistently had the lowest rates since 2009-10. Both PCNs had values significantly lower than England and Salford in all years between 2009-10 and 2023-24. The gap between the highest performing PCN, Walkden and Little Hulton, and the two lowest performing PCNs was 21 to 24 percentage points.
For the 50 to 64 year old cohort the situation was similar. Whilst Broughton (59.3%) and Salford South East (64.2%) were the worst performing PCNs in 2023-24 only Broughton has been consistently below both Salford and England averages. Salford South East has only been significantly worse than Salford and England since 2020-21. Again, Walkden and Little Hulton PCN was the best performing PCN, 13 to 18 percentage points higher than Salford South East and Broughton.
Table 1: In 2023-24 Broughton and Salford South East PCNs were the worst performing PCNs for cervical screening coverage in both age cohorts
| Primary Care Network | Coverage aged 25-49 | Coverage aged 50-64 |
|---|---|---|
| Broughton Health Alliance | 52.9% | 59.3% |
| Eccles and Irlam | 66.8% | 71.2% |
| Salford South East | 55.9% | 64.2% |
| Swinton | 71.7% | 74.9% |
| Walkden and Little Hulton | 76.8% | 77.5% |
| Salford average | 62.9% | 70.0% |
Inequalities in screening with respect to age, socio-economic deprivation and ethnicity have been supported by evidence from research papers and systemic reviews.
Although there is currently no published data on inequalities within cervical screening it is known, via the GP Patient Survey that Broughton PCN (55%) and Salford South East (59%) had the lowest proportion of patients from the White British ethnic group within Salford. For comparison, the 2024 results suggested that, 84% of Swinton’s and 74% of Walkden and Little Hulton’s population were White British.
Cancer Research UK reports higher incidence of cervical cancer in England in women living in deprived areas, with 520 cases each year linked with deprivation. It can be calculated from April 2025 GP practice population data that Broughton (60.8%) and Salford South East (58.6%) have the highest proportion of Salford patients living in the 20% most deprived areas of the country in. By comparison Salford overall had 51.6% of patients living in the 20% most deprived areas of the country.
Given that Broughton and Salford South East are characterised by higher levels of deprivation and a more ethnically diverse population compared to other areas of Salford it could be assumed that screening coverage was lower in these sub-groups. Unpublished NHS data support this assumption, indicating that cervical screening rates in Salford are lowest among individuals from Indian, Pakistani, other Asian, and Arab backgrounds. The data also demonstrate a clear socio-economic gradient in screening coverage, with participation decreasing as levels of deprivation increase. Notably, both age cohorts displayed a somewhat unexpected reduction in coverage in the least deprived quintile compared to the second least deprived.
Broughton and Salford South East PCNs had the youngest populations within Salford, with median ages of 28 and 30 respectively as of June 2025, compared to 33 across the wider Salford population. Although cervical screening is specifically targeted at women aged 25 to 64, the younger demographic profile of these PCNs may contribute to their lower screening coverage. This suggests that younger women within the eligible age range may be less likely to engage with the screening programme, particularly within the 25 to 49 programme.
An analysis by the ONS of age-standardised mortality rates (ASMR) for cervical cancer in England (2012–2019) revealed a notable increase among Black African females—from previously suppressed values through 2015–17 to 4.9 per 100,000 in 2017–19. This figure represented the highest ASMR recorded across all ethnic groups during the reporting period. While this trend warrants careful interpretation due to small sample sizes and its concentration in just two time periods, it may nonetheless have important implications for population health planning in Salford. According to the 2021 ONS Census, women of Black African ethnicity aged 25 to 64 were predominantly concentrated in the eastern wards of the city, including Pendleton and Charlestown, Broughton, Weaste and Seedley, and Ordsall. This geographic distribution is particularly significant, as approximately 90% of residents in these areas are registered with either the Broughton or Salford South East PCNs. Notably, as highlighted previously, these two PCNs report the lowest levels of screening coverage across the city.
Evidence from a large-scale longitudinal study in Sweden demonstrates that HPV vaccination before the age of 17 can reduce cervical cancer incidence by nearly 90% over an 11-year period. Despite this, HPV vaccination uptake in Salford has consistently lagged behind both national and regional benchmarks. In 2023-24, only 55.9% of 12–13-year-old girls in Salford received the vaccine — the lowest rate in North West England. This figure falls well short of the UK Government’s 90% target, and is significantly below the coverage in England (72.9%) and Greater Manchester (72.1%). To match the regional and national averages, Salford would have needed to vaccinate an additional 220–230 girls. Achieving the 90% target would have required vaccinating approximately 460 more girls. National data for 2023-24 also shows a clear gradient in HPV vaccination coverage by deprivation. Girls living in the most deprived areas had vaccination rates around 20 percentage points lower than those in the least deprived areas. Additionally, there is evidence that ethnic minority populations are less likely to receive the HPV vaccine, due to a combination of access barriers, cultural perceptions, and lower awareness. These disparities are particularly relevant for Broughton and Salford South East PCNs, which are among the most deprived and ethnically diverse areas in Salford. Alongside their historically low cervical screening rates, the risk of undetected and preventable cervical cancer is intensified.
Recognition and acceptance of the barriers to cervical screening, and then working towards removing them, are paramount to improving coverage. The Salford Screening Operational Group, which includes members from organisations such as GP practices and the wider NHS, Health Protection, Public Health and third sector, meet once a month with the aim of increasing screening coverage amongst Salford patients. The group consider the most recent data and examples of best practice in the three main screening programmes. Using evidence from groups such as Answer Cancer the group, alongside Neighbourhood Health and Wellbeing Partnerships, have implemented strategies such as:
These initiatives have predominantly been done on a hyper local level within PCNs. If there is sufficient evidence of their efficacy, and the resources are available, they should be rolled out on a Salford level.
The aim of increasing cervical cancer screening should be implemented in conjunction with a plan to increase HPV vaccination coverage. HPV vaccination stops 90% of cervical cancer cases and can reduce incidence in low socioeconomic groups. HPV vaccine and cervical cancer screening education should be integrated into school and college syllabuses to improve long term health literacy about cervical screening.
Salford will continue to press for national legislation guaranteeing paid time off for all cancer screening appointments, removing a key barrier to access.
It will also support the NHS shift to personalised HPV‑risk‑based screening intervals and digital invitations via the NHS app, alongside tailored assistance for those without the skills or tools to go online - ensuring digital inclusion.