Breaking down barriers to cervical screening – the evidence for HPV self-sampling
How researchers paved the way for NHS to offer ‘at home’ testing to those who are overdue screening The post Breaking down barriers to cervical screening – the evidence for HPV self-sampling appeared first on Cancer Research UK - Cancer News .
Cervical screening, a vital tool in preventing cervical cancer, can be an uncomfortable procedure for many. In the UK, women receive cervical screening invitations every few years until their mid-60s. Despite the success of national screening programs in preventing thousands of premature deaths since the late 1980s, attendance rates have been declining.
Currently, only two-thirds of women attend their appointments, putting them at greater risk of developing cervical cancer. Certain groups, such as deprived communities, ethnic minorities, and those with disabilities, are particularly affected by this decline in screening rates. Professor Peter Sasieni, co-lead of the Centre for Cancer Screening, Prevention, and Early Diagnosis at Queen Mary, University of London, believes that the system is in crisis and calls for quick improvements.
To address this issue, Sasieni and his team have been working on the YouScreen and HPValidate studies, which have led to the introduction of HPV self-sampling in the UK. This new method allows individuals to take samples at home using a vaginal swab, potentially increasing screening rates, particularly among underserved communities.
Cervical screening began in the UK as a series of local efforts in the mid-1960s and was later mandated nationally in the late 1980s. This national effort significantly reduced cervical cancer death rates by 75%, preventing around 2,000 premature deaths annually. The transition from Pap smears to liquid-based cytology improved accuracy and enabled HPV testing.
In 2010, HPV testing became the primary screening method in the NHS, reducing the need for cytology. Sasieni's colleagues hypothesized that self-testing could overcome various barriers associated with cervical screening, including discomfort, pain, and the invasive nature of the procedure. An early study showed that HPV self-sampling would be reasonable for women who are reluctant to attend for cervical smears.
However, early studies also highlighted potential drawbacks, such as participants' concerns about performing the test correctly and its impact on accuracy. Professor Jo Waller, now Professor of Cancer Behavioural Science at QMUL, emphasizes that self-sampling could help overcome embarrassment, dislike, and discomfort associated with speculum examinations, as well as issues related to scheduling and appointment difficulties.
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