Thousands of women every year could be spared invasive tests thanks to simple screening for the virus that causes cervical cancer.

Introducing a test for the human papillomavirus (HPV) alongside regular cervical screening cuts the number of women needing further investigation by more than a third, according to a study led by The Institute of Cancer Research.

HPV is a very common sexually-transmitted infection and causes most cases of cervical cancer. In many cases, the body clears the infection within two years, but some women have a persistent infection. These women with a current infection often need further tests, including a colposcopy (detailed examination of the cervix) or six-monthly repeat smears.

For those women who test negative for HPV, even if their cervical screening test shows mild or borderline abnormalities in the cervix, their risk of developing cervical cancer is low.
It is these lower-risk women, the new study suggests, that could go back to having routine three-yearly smear tests to check if their condition has changed, rather than being referred for invasive investigation.

The NHS in England is now incorporating the HPV test into regular cervical screening. The study, published in the British Journal of Cancer, examined more than 10,000 women aged 25 to 64 whose first smear test had shown mild or borderline abnormalities in the cervix.

Their cervical screening samples were tested for HPV, and the results showed that around 35% (3,581 women) were HPV negative and were able to return to routine screening.

Those women with a positive HPV result were then referred for a colposcopy without having to go through further smear tests.

Study author Dr Sue Moss, from The Institute of Cancer Research, said: "Our study shows that adding HPV testing significantly reduces the number of women sent for more invasive tests, when in fact they do not have any serious cervical changes."

Sara Hiom, director of health information at Cancer Research UK, said: "This is a welcome refinement to the highly effective cervical screening programme. This change has already saved thousands of women an anxious wait for extra tests and results, and should help lead to a more efficient screening programme."

Professor Julietta Patnick, director of the NHS Cancer Screening Programmes, said: "The NHS Cancer Screening Programmes is very pleased indeed with the results from the Sentinel Site project. The use of HPV testing that this paper reports is currently being incorporated into the screening programme nationwide and will be fully rolled out within the next year.

"By incorporating HPV testing into our current screening programme in this way, we will be able to significantly reduce the number of repeat cytology tests required and to target our colposcopy services more effectively. This is an important development in our programme enabling us to screen women more effectively and efficiently, reducing unnecessary procedures and minimising any associated anxiety."
 

Robert Music, director of Jo's Cervical Cancer Trust, said: "The results are very positive. We know that cervical screening can cause women anxiety and if the introduction of HPV testing can alleviate this, it can only be a good thing.”

"The test will enable thousands more women to go back into the routine three or five year programme, thus reducing the number of tests they go through. However, we also know from questions sent by women to our Ask the Expert service that being told you have or may have had HPV can cause a lot of anxiety."

"Therefore, it is vitally important that alongside the rollout of HPV testing, there are plans in place to ensure women are communicated with sensitively and carefully signposted if they want more information."