Cervical screening to change in the UK with HPV tests meaning fewer smears

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Cervical screening is changing across the UK, with a new HPV test meaning that women will only need five-yearly smears. Previously, women were invited for a smear test every 3 years.

A major study, which took data from 1.3 million women, shows that HPV testing can safely reduce the frequency of smear tests without missing any cases of cervical cancer. HPV (human papilloma virus) is a common infection. Most strains of HPV are harmless, but some increase the risk of cancers, including cervical cancer. The test for HPV infection offers a much earlier sign that a woman could be at risk of developing cervical cancer.

Prior to HPV testing, doctors could only use smear test samples to determine the level of risk based on whether there were already abnormal cells in the cervix. HPV infection can be identified before changes in the cells, enabling patients to undergo further checks or attend more frequent smear tests. In England, Scotland and Wales, HPV tests have already been introduced, but it has not become standard practice in Northern Ireland yet. Wales and Scotland have moved to 5-yearly screening. In England and Wales, invites are still sent out every three years. This will soon change to five-yearly appointments with HPV testing. 

The study, which was conducted by researchers at King’s College London and has been published in the British Medical Journal, confirms that fewer smears do not increase risks when used in tandem with HPV testing. The chance of abnormal cells developing between routine smears was 1 in 1,000 when HPV testing was used and 4 in 1,000 with cytology (cell) tests. Dr Matejka Rebolj, lead author of the study, described the results as “very reassuring,” explaining that the study confirmed that it was possible to prevent "just as many cancers as before” The study has been welcomed by Cancer Research UK and Jo’s Cervical Cancer Trust. Karis Betts, from Cancer Research UK, which was involved in funding the research.