This study used published mortality data and regression techniques to look at time trends in cervical cancer mortality between 1970 and 2000 in the UK and the Republic of Ireland. Mortality from cancer of the cervix has been declining in the UK for at least the past 30 years. The rate of decrease has been greatest in England, Wales and Scotland and has accelerated in these countries since the reorganisation of screening services in the late 1980s. Mortality in Northern Ireland is also decreasing, but at a lesser rate and without significant change over the same period. In contrast, cervical cancer mortality in the Irish Republic, which, unlike the UK, does not have comprehensive population-based screening, has been increasing by an average of 1.5% per year since 1978. The mortality rate, which was half of that in the UK in the late 1970s, now exceeds that in any of the region of the UK. The absence of population-based screening for cervical cancer in the Republic of Ireland is the most plausible explanation for these differences in trend.