The number of women who take up cervical screening has dropped to a 19-year low, a charity has warned.
Screening coverage across women aged 25 to 64 was at 72.7% as of March this year, down from 73.5% last year, new statistics show.
Charity Jo's Cervical Cancer Trust said the figure is the lowest for almost two decades.
This means that during 2015/16, 1.12 million women did not take up their screening invitation, the charity said.
The new figures from NHS Digital show that coverage in England was lowest among women aged 25 to 49, with just seven in 10 women in this age bracket taking up screening invitations.
Older women were more likely to get tested, with 78% of those aged 50 to 64 being screened.
The figures also show big regional differences, with 67% of women in London getting tested compared to 76% in the East Midlands.
Jo's Cervical Trust's analysis of the figures suggest that cervical screening attendance fell across every age group and almost every local authority in England.
Charity chief executive Robert Music said: "The new data makes bleak reading.
"As we see screening coverage go down year on year, we are also seeing the numbers diagnosed with cervical cancer rise.
"If we do not start to immediately reverse declining coverage then tragically we will see more diagnoses and lives lost from what is a largely preventable disease.
"Among women aged 25-29 coverage is significantly lower than any other age group at just 63.3% meaning over one in three young women are not attending a five-minute test that could literally save their life.
"9.9% of women eligible for cervical screening, aged 25-64, have never attended and this is a big concern.
"It is essential that government, commissioners and public health leads invest in ensuring that every woman understands the role of screening in preventing cervical cancer and the potential health implications of not attending.
"The Cancer Strategy for England acknowledges the health inequalities that exist as a result of low screening uptake, particularly among black, Asian and minority ethnic groups and communities of lower socio-economic status and we need to see these gaps closed. Targeted awareness and education campaigns at both a national and local level must be a priority alongside making screening more accessible.
"We are calling for urgent action to explore initiatives including self-testing, increasing provision of screening in sexual health clinics and allowing women to attend screening at GP surgeries other than the one they are registered with."
Health minister David Mowat said: "Cervical screening saves around 4,500 lives a year in England and I urge all women to decide to attend screening appointments when invited.
"By detecting any problems early, swift action can be taken to reduce the risk of more serious conditions like cervical cancer developing."