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HPV primary screening

 

  1. Public Health England, NHS Cervical Screening Programme: Colposcopy and Programme Management, 3rd edition, 2016.
  2. NHS Scotland, Scottish Cervical Screening Programme: Colposcopy and Programme Management, 3rd edition, 2017.
  3. O'Leary JJ. et al, Cervical screening: A new way forward (tests of risk and tests of disease), Health Research Board Open Research, 2018.

 

 

HPV primary screening is a way of testing the sample of cells taken at your cervical screening (smear test) appointment. It tests for a virus called high-risk human papillomavirus (HPV) that can cause cervical cell changes to develop into cervical cancer. 

England and Wales use HPV primary screening. Scotland and Northern Ireland will use HPV primary screening in the future. 

We also have information about:

What is HPV primary screening?

HPV primary screening is a way of testing the sample of cells taken during cervical screening. A lab tests your sample for a virus called high-risk HPV. High-risk HPV can cause cervical cell changes to develop into cervical cancer over time. If you have high-risk HPV, that same sample will be tested for cell changes. 

Not all cell changes will develop into cervical cancer, but it is important that they are monitored and treated if needed. 

Read more about HPV >

What happens if I do not have HPV?

If high-risk HPV is not found, your sample will not be looked at for cell changes. It is very unlikely cell changes or cervical cancer will develop without high-risk HPV. You will be invited for cervical screening in 3 or 5 years. 

What happens if I have HPV?

If high-risk HPV is found, your sample will be looked at for cell changes. If there are no cell changes, you will be invited back for cervical screening in 1 year. This is to make sure the HPV has cleared.

If high-risk HPV and cell changes are found, you will be invited for further tests at colposcopy.

Read more about colposcopy >

HPV primary screening pathways

A flowchart showing the pathways you may follow, depending on your HPV primary screening result.

When will HPV primary screening start?

HPV primary screening has started in England and Wales. In the rest of the UK, it is starting:

  • in Scotland from the end of March 2020
  • in Northern Ireland the start date is to be confirmed.

What are the benefits and risks of HPV primary screening?

The National Screening Committee, which oversees all screening programmes in the UK, recommended the move to HPV primary screening because evidence shows it is a better test:

  • HPV primary screening is the best way to find out who is at higher risk of developing cervical cell changes or cervical cancer. Almost all cervical cancers are linked to high-risk HPV. By knowing who has high-risk HPV, we can make sure that we monitor the virus and find any cell changes early, before they potentially develop into cervical cancer. 
  • HPV primary screening is a more accurate test than cytology. This means it is better at detecting cell changes overall, as well as detecting them earlier. 
  • HPV primary screening could be done with a self-sample kit in the future. This would mean you could take a swab from your vagina, in the privacy of your home. There is ongoing research to find out whether self-sampling could be offered as part of the NHS national screening programme. 

All tests have some risks:

  • Like all screening tests, HPV primary screening isn't completely accurate. There is a small chance that your result could be wrong. 

What is cytology?

Our body is made up of cells – you can think of them as the building blocks of our body. Cytology is the study of individual cells in the body. In cervical screening, this means that the cells taken during your appointment are looked at under a microscope for changes. Cytology is used in Scotland and Northern Ireland. 

Read more about cell changes >

If cell changes are found, what happens next depends on where you live:

If any kind of cell changes are found, the sample is not tested again and you are invited to colposcopy.

Read more about colposcopy >

Scotland will use HPV primary screening from the end of March 2020. 

If borderline or low-grade cell changes are found, the same sample is tested for high-risk HPV. This is because it is unlikely for cell changes to develop into cervical cancer without high-risk HPV. 

If high-grade cell changes are found, you are invited to colposcopy at your local hospital, where a specialist takes a closer look at your cervix.

Read more about colposcopy >

Northern Ireland will use HPV primary screening in the future.

Cytology pathways

A flowchart showing the possible pathways you may follow, depending on your cytology results.

 HPV primary screening FAQs

It is possible to have cervical cell changes without having high-risk HPV. However, it is unlikely that these cell changes would develop into cervical cancer. The National Screening Committee recommended the move to HPV primary screening because it is more accurate at showing who is at higher risk of cell changes that may develop into cervical cancer.

The short answer is no. HPV primary screening means your sample will only be tested for cell changes if you have high-risk HPV.

The only way to have your sample checked for cell changes is to book cervical screening privately, for a cost. If you are worried about cervical screening not checking for cell changes, it is best to speak with your GP or practice nurse. They will be able to answer any questions and offer reassurance.

If you live in England or Wales, your next cervical screening test should useHPV primary screening. If you are unsure, it is best to speak with your GP surgery for a definite answer. 

More information and support

Your GP or practice nurse should be able to answer any questions you have about HPV primary screening and your results.

We know that HPV and HPV primary screening can be confusing, so if you have questions we are also here to support you:

  • Our trained volunteers can offer emotional support on our free Helpline on 0808 802 8000check the opening hours >
  • You may want to join our online forum to talk with others >
  • If you have a medical question, you can submit it to our panel of experts using our Ask the Expert service >

Read more about cervical screening results >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it. 

References

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

Read more about how we research and write our information >

HPV >

Understand what HPV is and how it is linked to cell changes and cervical cancer.

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Date last updated: 
23 Dec 2019
Date due for review: 
23 Oct 2021

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