Ireland’s national cervical screening program now includes trauma-informed care to help women who avoid screening due to past trauma, especially sexual violence.
Equity as the driving force
The Cervical Cancer Elimination Plan 2025-2030 prioritizes equity. In 2022-23, 75% of eligible women aged 25 to 65—about 1.3 million—took part in screening. The remaining 25% account for 40% of cervical cancer cases. The plan focuses on underserved groups, including a study on HPV self-sampling for those who find clinic visits difficult.
Dr Rachael Comer, Education and Training Manager at CervicalCheck’s Screening Training Unit (STU), describes trauma-informed care as a framework for delivering services with awareness of how trauma can affect people’s lives. The approach acknowledges that trauma, whether from sexual assault or coercive control, can make screening distressing. A 2023 report found 52% of Irish women had experienced sexual violence.
Training and on-site services expand access
All sample-takers in Ireland now receive training on trauma-informed practices. The training teaches how to recognize trauma signs and obtain ongoing consent. The STU introduced a clinical update on the topic in 2025, available through CervicalCheck’s e-learning platform. The program covers interactions with both clinical and administrative staff to reduce fear and rebuild trust.
On-site screening programs have improved access. At Limerick Female Prison, women previously had to be escorted to a GP practice by prison staff to access cervical screening. The CervicalCheck Programme has collaborated with services, including prisons and sexual assault treatment units (SATUs), to develop trauma-informed screening.
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Older women and self-sampling as next frontiers
Women over 50 are less likely to attend screening, even though they face higher risks due to lower HPV vaccination rates. One in four in this group skips screening, often because of misconceptions about post-menopausal necessity or physical challenges. CervicalCheck has worked with ambulatory gynaecology units and menopause clinics to improve access by including screening discussions in routine care.
A pilot program targets women overdue for screening by six months with text reminders. Those who’ve never attended receive a call from a practice nurse or GP. This adds a personal touch to the national call-recall system without replacing it.
Self-sampling may also increase participation. A feasibility study in GP settings this year will test vaginal HPV self-tests. Women at participating practices will receive a self-sample kit alongside the standard test. Results will be compared to assess logistics and patient feedback. If approved, self-sampling would first be offered to women who’ve never attended or are overdue.
The STU, led by nurses, manages training for over 5,500 registered sample-takers. Its programs include beginner and advanced tracks, with updates required every three years. Recent topics include screening for women over 50. Clinician feedback has helped create resources, such as a reference chart for benign cervical variants, which has reduced unnecessary referrals.
While the program’s reach is broad, the remaining gaps remain clear. For women with trauma histories, a compassionate approach ensures no one is overlooked in the effort to eliminate cervical cancer by 2040. Modern eye care has shown how early detection can change outcomes for conditions that often go unnoticed.
