HOME tests for the human papillomavirus (HPV) could help 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, a worrying number of women ignore the opportunity to be screened.
The study which was funded by research for Patient Benefit (RfPB) Programme was published in the British Journal of Cancer. The study looked at 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 the women, while the other half were sent another invitation for cervical screening.
Around 10 per cent of women in the first group responded to receiving kits. This was made up of 96 women (6.4 per cent) doing the self-sample and in addition, 57 (3.8 per cent) booking an appointment to be screened in the usual way.
In the other group, 68 women (4.5 per cent) went for a smear test after receiving a third invitation.
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 – the most common form of cancer in women under 35 – can prevent cases of the disease.
But over the last ten years the coverage rate – 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 edging lower and is now 78.9 per cent, just below the government’s target of 80 per cent. A one per cent fall in the coverage rate accounts for around 165,000 women.
Dr Adeola Olaitan, consultant gynaecological oncologist at the Harley Street Clinic confirms that the number of younger women who comply with the cervical cancer screening programme has fallen over the last 10 years, and that home testing kits may provide a solution,
“Despite the recent publicity surrounding the sad demise of Jade Goody, the proportion of women aged 25-64 in England who comply with the cervical cancer screening programme has fallen over the last 10 years and is now 78.9 per cent, just below the government’s target of 80 per cent. Screening rates are even lower in London and are particularly problematic in areas with high ethnic minority populations.
The reasons for non-compliance are complex but include fear, embarrassment and a failure to understand the purpose of screening. This suggests that the NHSCSP should consider novel approaches.
Home screening for HPV may offer a solution. The National Screening Programme has experience of home screening in the bowel screening programme where uptake rates are acceptable. Of 478 250 residents of the pilot areas who were invited to take part in the screening programme, uptake was 56.8 per cent (n = 271 646).
This is a lot higher than the response rate in the Szarewski study where around 10 per cent of women responded to receiving home HPV screening kits. It would be reasonable to expect uptake rates to improve over time as women become more familiar with the concept and this approach offers real hope for improving the cervical screening coverage rate and reducing cervical cancer incidence.”