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2024

Millions of women could be offered life-saving new DIY smear tests for free on the NHS

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MILLIONS of women could be offered a “game-changer” DIY cervical screening test via the NHS that can be done at home for free.

The self-testing kit – which is quick and easy to use – could lead to around 400,000 more cancer checks every year, with NHS leaders saying they’re looking to make it available in England.

PA
A DIY cervical screening test, known as the YouScreen test tube, that women can do at home could be rolled out on the NHS[/caption]

It works by detecting human papillomavirus (HPV), a group of viruses that tend to cause no symptoms but can lead to the development of cervical cancer.

About 13 high-risk types of HPV are known to cause 99.7 per cent of all cervical cancers.

A new trial, known as the King’s College London YouScreen trial, is the biggest to date and shows how the DIY kit can boost the numbers of women getting screened.

Figures show that cervical screening uptake is declining, with nearly a third of women in England – particularly younger women – not taking up their most recent test.

Experts say women may refuse testing due to a lack of convenient appointments, embarrassment and worries about the test causing pain.

In the new trial, women used a vaginal swab – like a long cotton bud – to take their sample either at home or in their GP practice.

Those who took the test at home then simply posted off their kit for free to a laboratory.

The trial results suggest over a million more women could undergo screening over three years in England – about 400,000 more every year – if the DIY tests were rolled out.

Lead investigator Dr Anita Lim, from King’s College London, said: “Self-sampling has been hailed as a game-changer for cervical screening and we now have evidence in a UK population to show that it really is.

“Women who don’t come for regular screening are at the highest risk of developing cervical cancer.

“Cervical screening participation has been falling in England for over two decades.

“Currently a third of eligible women aren’t getting screened regularly and in some parts of London this is as high as 50 per cent.

“It is crucial that we make cervical screening easier by introducing innovations like self-sampling, alongside the current cervical screening programme, to help protect more people from this highly preventable cancer.

“Self-sampling can do this by offering people choice and convenience.”

Published in the journal eClinicalMedicine, the trial saw 17,604 kits sent to people directly by mail, with 13 per cent of them returned.

Some 10,849 women were also offered a kit when speaking to their GP surgery about something else.

Eighty-five per cent accepted the kits and 6,061 (56 per cent) returned a self-sample, either through the post or after taking the test at the surgery.

Half (52 per cent) of all those who returned a self-sample were at least two years overdue screening (including those who had never previously been screened).

What is HPV?

HUMAN papillomavirus (HPV) is the name of a very common group of viruses.

They don’t cause any problems in most people, but some types can cause genital warts or cancer.

There are more than 100 different types of HPV, which affects the skin and is passed on through skin-to-skin contact during sex.

Many types of HPV affect the mouth, throat or genital area.

Most people will get some type of HPV in their life, though in most cases they won’t experience any problems from it.

In some people, some types of HPV can cause:

  • Genital warts – painless growths or lumps around your vagina, penis or anus
  • Abnormal changes in the cells that can sometimes turn into cancer

Some high-risk strains of HPV have been linked to cancer, including:

  • Cervical cancer
  • Anal cancer
  • Penile cancer
  • Vulval cancer
  • Vaginal cancer
  • Some types of head and neck cancer

You can’t fully protect yourself against HPV, but there are things that can help:

  • Wearing condoms can help protect you against HPV, but they do not cover all the skin around your genitals, so you’re not fully protected.
  • The HPV vaccine protects against the types of HPV that cause most cases of genital warts and cervical cancer, as well as some other cancers. It does not protect against all types of HPV.

The HPV vaccine is recommended for children aged 12 to 13 years old and people at higher risk from HPV.

If you missed getting vaccinated when you were 12 or 13, you can get the HPV vaccine for free on the NHS if you’re a woman under 25 or a boy born after September 1, 2006.

Source: NHS

Some 64 per cent were from ethnic minority groups and 60 per cent from deprived populations.

The researchers said routine rollout of the kits in England could increase screening coverage from 69.9 per cent to 77.3 per cent.

Dr Lim said: “The YouScreen trial has given us the evidence we need to demonstrate that self-sampling helps get more women screened in England.

“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.”

Dr Lim said the 13 per cent figure for people returning kits that were mailed to their homes is in line with previous studies, but it was exciting that 56 per cent of people returned a kit when offered one at their GP practice.

She said this is “very promising in this group of people who haven’t been coming for screening”.

NHS director of screening Deborah Tomalin said: “It’s extremely promising that this study suggests simple DIY swab tests could have a really positive impact in supporting more women to take part in cervical screening from their own homes, and the NHS will now be working with the UK National Screening Committee to consider the feasibility of rolling this out more widely across England.

“In the meantime, if you are invited for cervical screening by the NHS, it’s vital that you come forward – it could save your life and remains vital towards our ambition of eradicating cervical cancer in England within the next two decades.”

Professor Peter Sasieni, head of the research group at King’s College London and now at Queen Mary University of London, said the UK is “well on the way to turning cervical cancer into a rare disease”.

He said while the introduction of an HPV jab in schools was offering huge benefit, women born before 1990 still need regular screening as they have not been vaccinated against cervical cancer.

When is cervical cancer screening offered?

The NHS invites women for screening every three to five years depending on their age, or more frequently if HPV is detected, and screening is known to save thousands of lives every year.

It’s advised that all women and people with a cervix go for regular cervical screenings – previously known as smear tests – between the ages of 25 to 64.

You’ll get a letter in the post inviting you to make an appointment.

How to protect yourself against cervical cancer

CERVICAL cancer is most commonly diagnosed in women in their early 30s, with around 3,200 new cases and 850 deaths each year in the UK.

According to CRUK, the five-year survival rate is around 70 per cent – and the earlier it is caught, the better.

Cervical screening programmes and HPV vaccines have reduced rates and save 4,000 lives each year.

It is vital you attend your smear test and get jabbed when invited, and that you know the symptoms of cervical cancer to look out for.

These aren’t always obvious, and they may not become noticeable until the cancer has reached an advanced stage.

But you might notice:

  • Unusual bleeding (often after sex, between periods, or after the menopause)
  • Pain and discomfort during sex
  • Vaginal discharge (often unpleasant smelling)
  • Pain in your lower back, between your hip bones or in your lower tummy

Women are invited to have regular cervical screenings between the ages of 25 and 64. How often depends on your age.

The HPV vaccine, which helps protect against the virus, is recommended for children aged 12 to 13 and people at higher risk from HPV.

Source: NHS and Cancer Research UK

Women between the ages of 25 and 49 will get an invite every three years, those between 50 and 64 will get one every five years and women over 65 will only get called back if a recent test was abnormal.

If HPV is found, women may be invited back for another test in a year or have a different test to look at their cervix.

Other countries such as the Netherlands, Australia, Denmark and Sweden have already introduced the self-testing kits.

A Department of Health and Social Care spokesman said: “It’s crucial that access to screening and tests is made as simple and convenient as possible.

“If we’re going to succeed in our mission to make the NHS fit for the future, we need to catch illness earlier so we can treat it faster.”