Date Published: 16 March 2011

Home tests for human papillomavirus (HPV) may increase cervical screening coverage

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Recent research suggests that home tests for the human papillomavirus (HPV) could help to increase the take-up of cervical screening among women who do not respond to screening invitations.

Despite publicity surrounding Jade Goody who died from cervical cancer at the age of 27, Cancer Research considers that a "worrying number" of women ignore the opportunity to be screened.

The recent study, which has been published in the British Journal of Cancer (see reference to paper below), considered 3000 women from the Westminster Primary Care Trust who had not responded to at least two screening invitations. Self-sample HPV test kits were sent to half of those women, while the other half were sent another invitation for cervical screening. Approximately 10% of women in the first group responded to receiving kits. This consisted of 96 women (6.4%) doing the self-sample and 57 women (3.8%) booking an appointment to be screened in the usual way. However, in the case of the second group who were sent a third or subsequent invitation for a standard medical screening appointment only 68 women (4.5%) went for a smear test.

Dr Anne Szarewski, lead author of the study and a Cancer Research UK cervical cancer expert, said:

" Women who don't go for cervical screening face a higher risk of cervical cancer so it's important to encourage these women to take part. HPV self-sampling could be an effective way of getting women to be screened.
_ Home testing for HPV is as accurate as samples taken by doctors and can help address some of the reasons, like finding time or being embarrassed, that women often give as reasons for not attending screening."

Screening for cervical cancer, which is the most common form of cancer in women under 35, can prevent cases of the disease. However, over the last ten years the "coverage rate", that is the proportion of women aged 25-64 in England who have had a cervical screening test at least once in the previous five years – has been decreasing and is now 78.9%, which is just below the government's target of 80%. A decrease of only 1% in the coverage rate amounts to approximately 165,000 women.

The authors state the study should be repeated in other areas to find out if the level of response seen in Westminster is likely to be representative of the rest of the country.

In the HPV home test group eight women tested positive for HPV - two had high grade stages of abnormal cells and one had an invasive cancer. Dr Szarewski said this showed that self-sampling had the potential to pick up even more women with abnormalities.

While most women infected with HPV do not develop cervical cancer, the virus is the major cause of the disease.

Sara Hiom, director of health information at Cancer Research UK, said:

" Although we saw a surge in the number of women going for smear tests immediately after the sad experience of Jade Goody, we know a significant proportion of women are not going for screening.
_ Cervical cancer is one of the few cancers that can be prevented through screening by picking up early changes in the cells which can lead to the disease. So finding a way to screen women who do not go for smear tests could be very valuable.
_ HPV home tests could help overcome some of the barriers women face, especially those from deprived backgrounds or ethnic minorities where cultural barriers play a role.
_ More research is needed to see if the response to self-sampling around the country would be generally higher but this study suggests it may have the potential to prevent even more cases of cervical cancer along with the current screening programme."

Reference to Paper:
Szarewski, A et al., HPV self-sampling as an alternative in non-attenders for cervical screening – a randomised controlled trial, British Journal of Cancer (2011) DOI:10.1038/bjc.2011.48 (This information was made available via a Press Release from the British Journal of Cancer.)

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