NHS in London will trial DIY cervical smear tests to detect cancer-causing HPV in women who are more than 15 months overdue for ‘life-saving’ screening
- Women who are overdue cervical screens in some boroughs will get home tests
- The vaginal swab tests are used to detect HPV, a virus that can cause cancer
- Vaccines expected to wipe out the virus in future but women unprotected
- HPV is spread by sex and often does not cause any symptoms or problems
Thousands of women will be given DIY smear tests to do at home in a bid to boost screening uptake.
The NHS will dish out more than 31,000 home kits in London, which will allow women to perform the potentially life-saving check at home for the first time.
It is hoped the pilot will encourage women who are too embarrassed to have the test conducted by a health professional at a GP surgery or health centre.
If successful, health professionals say it could soon be rolled out nationally.
The tests – which look for strains of the human papillomavirus (HPV) responsible for 99 per cent of cases of cervical cancer – will be posted to women aged 25-64 who are 15 months overdue for a check.
The NHS’s screening programme invites all women over the age of 25 for regular swabs, starting at one appointment every three years and then decreasing to once every five years for over-50s.
Although the HPV vaccine, brought into use in 2008, is expected to all but eliminate the virus from Britain in the coming generations, women who turned 12 before then may still be at risk from the virus.
HPV viruses are spread through sex and mostly do not cause any symptoms or serious harm, but may raise the risk of cancer in later life.
Cervical cancer can develop at a young age, often affecting women in their 30s and 40s, and around half of women who develop it die within 10 years of their diagnosis.
Smear tests are swabs done inside the vagina that can detect HPV, a sexually-transmitted virus that causes almost all cases of cervical cancer (stock image)
Dr Anita Lim, from King’s College London, who is leading the study, said self-sampling is a ‘game-changer for cervical screening.’
She said: ‘We know many women aren’t coming forward for screening and almost half of women in some parts of London aren’t up to date with their cervical screening.
‘It’s an intimate procedure and a variety of barriers can stop people from attending, even though it can be a life-saving test.
‘This simple and convenient swab means it can be done in the privacy and comfort of your own home.
HPV VACCINE ‘COULD ERADICATE CERVICAL CANCER’
Public Health England said last year that the HPV vaccine could all but wipe out cervical cancer among young women.
Real-world data, it said, shows HPV infections have gone from affecting 15 per cent of women to fewer than two per cent in just 10 years since the vaccine was brought into use.
HPV causes almost all cases of cervical cancer and many experts believe that by stopping it spreading they will be able to wipe out the disease in England.
‘Our analysis finds that the near perfect efficacy of HPV vaccination in trials is realised in real-world settings,’ said Professor Peter Sasieni, who conducted a study on the vaccine’s effects.
‘These results imply that the impact of HPV vaccination on preventing cervical cancer could be even greater than estimated previously.’
The vaccine was developed to prevent HPV types 6, 11, 16 and 18 from spreading.
Types 16 and 18 cause more than 70 per cent of cervical cancer cases in the UK, while types 6 and 11 cause 90 per cent of of genital warts cases – the jab protects against both.
Professor Sasieni’s research used data from a review which combined 65 other studies from 14 countries.
It found the jab was 92 per cent effective within four years of it being given; 99.8 per cent effective after five years; and 97.6 per cent effective overall.
Cancers in both male and female genitals and reproductive systems, as well as of the rectum and the mouth and throat, may all be linked to the HPV viruses.
A report published in February 2019 predicted that the cancer cases would be cut in half by 2050 and eradicated completely by 2100.
Professor Sasieni’s letter was published in medical journal The Lancet.
‘Women who don’t come for regular screening are at the highest risk of developing cervical cancer, so it is crucial that we find ways like this to make screening easier and protect women from what is a largely preventable cancer.’
Screening for the disease in Britain has fallen to an all-time low with around five million women currently overdue for testing.
Nearly a third of British women ignored their latest invitation and are at risk because they have gone several years without a smear test.
Experts believe offering them the chance to test themselves in the privacy and comfort of their own home would appeal to the many women who are too embarrassed or busy to attend a clinic.
Studies have shown the DIY kits can increase screening among these hard-to-reach groups by up to 50 per cent.
The trial will target people living in the London Boroughs of Barnet, Camden, Islington, Newham and Tower Hamlets, where screening appointment attendance is low.
Women who are six months overdue for their test and attend GPs surgeries involved with the trial will also be offered an at-home kit.
‘This is an important new way to make screening easier for thousands of women,’ said Professor Peter Johnson, national clinical director for cancer for the NHS in England.
‘We know there are lots of reasons why women might not attend a screening appointment, including worries about Covid.
‘GPs have taken extra precautions to make surgeries safe, and these home kits give thousands of women another option to keep up to date with their screening.
‘We would urge every woman to make sure they have their smear test – the earlier HPV is detected the better. It could save your life.’
Women taking part in the YouScreen trial, which is being jointly run by NHS England, Public Health England and Kings College London, will follow the instructions on the test and then post their swabs back for analysis.
They will receive their result in the post, and if HPV is detected they will be contacted for a follow-up appointment.
Ruth Stubbs, National Cervical Screening Programme manager at PHE, said it is the first step in getting closer to HPV self-sampling at home for women across England.
She said: ‘PHE is also working on a clinical validation study to inform a larger national evaluation of HPV self-sampling at home.
‘This work together with the findings from the YouScreen London study, will provide data from England to inform the UK National Screening Committee on the potential impact of offering HPV self-sampling on the prevention and early detection of cervical cancer.’
Kate Sanger, from Jo’s Cervical Cancer Trust, said: ‘Self-sampling removes so many of the challenges to cervical screening and through our research we know it is very much wanted by women.
‘It has been fantastic to be part of this study and we hope it leads to change that will save lives and the trauma a cervical cancer diagnosis can bring.’
WHAT IS HPV? THE INFECTION LINKED TO 99% OF CERVICAL CANCER CASES
Up to eight out of 10 people will be infected with HPV in their lives
Human papilloma virus (HPV) is the name for a group of viruses that affect your skin and the moist membranes lining your body.
Spread through vaginal, anal and oral sex and skin-to-skin contact between genitals, it is extremely common.
Up to eight out of 10 people will be infected with the virus at some point in their lives.
There are more than 100 types of HPV. Around 30 of which can affect the genital area. Genital HPV infections are common and highly contagious.
Many people never show symptoms, as they can arise years after infection, and the majority of cases go away without treatment.
It can lead to genital warts, and is also known to cause cervical cancer by creating an abnormal tissue growth.
Annually, an average of 38,000 cases of HPV-related cancers are diagnosed in the US, 3,100 cases of cervical cancer in the UK and around 2,000 other cancers in men.
What others cancers does it cause?
- Throat
- Neck
- Tongue
- Tonsils
- Vulva
- Vagina
- Penis
- Anus
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