Going to the GP to get a cervical screening is not generally something to look forward to – even though it has the potential to save lives.
Despite efforts to increase update, many women are put off by the speculum, the medical environment, or having to undress in front of a stranger.
A ‘game changing’ new test could soon make the process much simpler, with a DIY swab that can be used at home, with the NHS now looking into rolling it out across England.
A trial by King’s College London proved successful in reaching those who previously had not taken up their screenings.
Researchers estimate if it is used more widely, a million more patients could undergo screening every three years in England – or 400,000 more every year.
Screening looks for the presence of human papillomavirus (HPV), a group of viruses which cause no symptoms but which can lead to cervical cancer. About 13 high-risk types of HPV are known to cause 99.7% of all cervical cancers.
All women and people with a cervix between the ages of 25 and 64, including trans men, should go for regular cervical screening, the NHS says.
If HPV is detected, further tests can be carried out to look at whether cells show any abnormal changes.
Figures show cervical screening uptake is declining, with nearly a third of women in England – particularly younger women – not taking up their most recent test.
The YouScreen trial, the biggest study to date, offers a promising way of turning this around.
Women in the study used a swab, like a long cotton bud, to take the sample from the top of their vaginas themselves either at home or at their GP practice. Those who took the test at home then simply posted off their kit for free to a laboratory.
After the coronavirus pandemic, we are well used to testing ourselves with swabs so the new test would just be doing it in a different place.
Other countries such as the Netherlands, Australia, Denmark and Sweden have already introduced the self-testing kits.
Lead investigator Dr Anita Lim said: ‘Currently a third of eligible women aren’t getting screened regularly and in some parts of London this is as high as 50%.
‘It’s really encouraging that we received self-samples from groups that have been historically underserved including people from deprived and ethnic minority backgrounds, LGBTQI+, people with learning disabilities and victims of sexual violence.’
Published in the journal eClinicalMedicine, the YouScreen trial included 17,604 kits being sent to people directly through the mail, of which 13% were returned.
Some 10,849 women were also offered a kit when speaking to their GP surgery about something else, of whom 85% accepted and 6,061 (56%) returned a self-sample either through the post or took the test at the surgery.
Half (52%) of all those who returned a self-sample were at least two years overdue screening (including those who had never previously been screened).
Some 64% were from ethnic minority groups and 60% from deprived populations.
The researchers said routine rollout of the kits in England could increase screening coverage from 69.9% to 77.3%.
The introduction of an HPV jab in schools has made a big impact on reducing cervical cancer rates.
But women born before 1990 will not have received the jab so are more at risk.
The NHS invites those eligible for screening every three to five years depending on their age, or more frequently if HPV is detected.
The NHS will now work with the UK National Screening Committee to consider the feasibility of rolling this out more widely across England.
But until then, if you get an invitation to cervical screening it’s still ‘vital’ to accept it, a spokesperson said.
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