Reducing how often many women are screened for cervical cancer is safe and should be extended across the UK, experts have said.
A study of 1.3million women in England has found evidence to support a longer gap between cervical screening, also known as smear tests, as long as the person has tested negative for Human papillomavirus (HPV), a very common group of viruses that is often sexually transmitted.
Researchers from King’s College London, the University of Manchester and the NHS analysed data from the NHS Cervical Screening Programme in England.
The results, published today in the British Medical Journal (BMJ), show screening every five years prevents just as many cancers as screening at three-year intervals, because the test used in cervical screening has changed and is more accurate.
The new test, introduced in 2019, is known as HPV primary screening and is more accurate at detecting who is at higher risk of developing cervical cancer.
Most people will get some type of HPV in their life and almost all cervical cancers are caused by the infection.
While often harmless, it can sometimes cause abnormal cells to develop in the cervix. If these abnormal cells are not treated, they can turn into cancer.
Before 2019, cytology tests checked cervical cells for abnormalities first. If found, they would then be tested for HPV. These tests were recommended every three years.
Northern Ireland still uses cytology tests but cervical screening in England, Wales and Scotland now uses HPV primary screening, following a recommendation by scientists.
‘Introducing HPV screening earlier could have prevented my cancer’
Laura Flaherty, above, was 31 years old when her cervical cancer was detected as a result of a smear test.
As it was before HPV screening was introduced in 2019, the mother-of-two believes it could have been picked up earlier – or even prevented – had the screening system changed.
Ms Flaherty, now 35, said: “In most cases screening picks up any changes before they can develop into cancer so it can prevent you from ever getting it. While I’ve had the all clear, having cancer still affects me today, my treatment means I can no longer have children and the mental impact still gets to me.
“I’m not a scientist but I think it’s important that all the evidence for decisions around screening is really clearly communicated as big changes can sound quite scary. To me the priority should be getting more women and people with a cervix screened and so many don’t go still which is really worrying.
“I think we need to make screening easier, as so many women find it uncomfortable or embarrassing or even struggle to get to the GP. Home HPV testing is something we need to see, so that you can take a test in your own home. Awareness campaigns are also important so we can remind people why the test exists and not to ignore their invite.”
Lead author Dr Matejka Rebolj, senior epidemiologist at King’s, said: “These results are very reassuring. They build on previous research that shows that following the introduction of HPV testing for cervical screening, a five-year interval is at least as safe as the previous three-year interval. Changing to five-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.”
Michelle Mitchell, chief executive of Cancer Research UK, which funded the study, said: “This large study shows that offering cervical screening using HPV testing effectively prevents cervical cancer, without having to be screened as often. It’s important to remember, screening is for people without symptoms. So, if you notice any unusual changes for you, do not wait for a screening invitation – speak to your doctor.”
Stephen Duffy, professor of cancer screening at Queen Mary University of London, said: “These results indicate that with primary HPV screening, we can be confident that a five-year interval in those screened negative will be at least as effective as a three-year interval with cytology, and probably more effective.”
The Department of Health has been approached for comment.