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Across the UK, cervical screening (smear test) attendance has been falling. Difficulty getting appointments, embarrassment, lack of time and having a physical disability are just some of the factors contributing to this trend. One way to tackle this is providing women with the option to self-sample and this is something we have been calling for, for a long time.
You might have seen recently in the news that there is going to be a pilot scheme in London looking at the best way to offer self-sampling to women as part of the cervical screening programme. You may have seen it called a few different things such as ‘DIY smear tests’, ‘HPV self-tests’ and ‘home-testing kits’ – essentially, they’re all the same thing.
The pilot will hopefully be running later this year and, if it is successful, could mean that the national screening programmes will soon be able to offer self-sampling to all women and this would be fantastic!
We know that lots of people have questions about self-sampling and about this pilot, so hopefully the below will help.
For many people, making or attending a cervical screening appointment can be really difficult. There are lots of reasons for this, such as availability of appointments, physical disability and past traumatic experiences. Self-sampling means women can take the test into their own hands and take a sample in the privacy of their own home.
As you may be aware, the UK is currently moving to HPV primary testing (or screening) in the cervical screening programme. There will be no changes to cervical screening appointments in GP surgeries, but the sample taken will be tested for HPV first, rather than for cell changes (abnormal cells) first. You can read more about HPV testing here.
You might be wondering why we are changing to test for HPV first. HPV causes 99.7% of cervical cancers, so testing for HPV means we can identify who is most at risk of developing cell changes or cervical cancer. This means we can give the right people the care they need as early as possible. We have more information about HPV.
A self-sample will also test for HPV so it is the same as the new method of testing cervical screening samples.
Yes! If the kit is used correctly, following the instructions that come with it, evidence from many studies shows that women are able to collect good samples and self-testing gives very accurate results.
It’s not like doing a traditional test in your own home, as there is no speculum involved. They involve a a swab (like a long cotton bud) or a soft brush that you use to collect a sample from your vagina. An example of what this might look like is in the picture. Don’t worry, you don’t have to touch your cervix with the swab. The tests will come with detailed instructions that should be really simple to follow and taking a sample takes just a few minutes. Then you put it in the post to send it to the laboratory for testing. The results will be sent to you in the post, just like a usual screening result.
The pilot aims to find out the best way to offer HPV self-sampling to women who have not responded to their invite. The areas of North and East London selected for the pilot have been chosen because their uptake of cervical screening is particularly low and the women invited to take part are at least 6 months overdue cervical screening.
Women who have HPV in their self-sample will be asked to have a standard cervical screening test taken by a doctor or nurse, at a GP practice or wherever they would normally go for a screening appointment. It is estimated only a small number of women will have to do this (about 13%).
We, along with Public Health England, are hoping that the self-sampling kits can reach people who have not been able to access screening but wish to.
If the pilot is successful, we hope to see it implemented more widely in the future. Other countries, such as Australia and Denmark, already offer self-testing and have seen fantastic results from it – more women are getting screened, leading to cervical cancer being prevented or diagnosed at an early stage.
Self-sampling is not currently part of the cervical screening programme and this will be the first pilot for HPV self-sampling in the UK. This means that the exact details of how the test is offered could change if it was made widely available.
If you live in the areas that have signed up to the pilot, you may be offered the self-sampling kit if you are 6 months or more overdue for cervical screening.
Depending on how long ago your last screening was, the kit will be:
The pilot is still in the planning stages, but it is aiming to begin in September 2019 and will run for 6 months. We are looking forward to being able to update you on how it progresses, so watch this space!
While we would like everyone to have access to self-sampling, this is a pilot running in North and East London. Hopefully the results of the pilot will mean that anyone who wishes to will soon able to have the option to use a self-sample. While self-sampling kits are currently available to purchase privately, they are not part of the NHS cervical screening programme and pilots such as this one are essential to ensure they are introduced in the safest and most effective way.
If you live in the areas where the pilot is running and fit the criteria, then you may receive a letter later this year, or be offered a kit through your GP practice. If you are invited for normal cervical screening, please don’t put off booking an appointment to wait for a kit. If your GP practice is not part of the project or you do not fit the specific criteria, then you may not be part of the study.
Keep an eye on our blog, newsletter and social media for updates about the above pilot and self-sampling in general. If you still have questions, then don't forget our helpline is here for you on 0808 802 8000