Some women may be able to go as much as 10 years between cervical screening appointments, according to the results of a key government-funded trial on HPV testing.
The long-term study of 24,500 women attending routine screening appointments in Manchester found that women aged over 40 who have a negative HPV test do not need to be screened for another decade.
In a Health Technology Assessment which will feed into the National Screening Committee’s recommendations, researchers said there is also evidence that younger women with a negative HPV test could go longer than the current three years between screening intervals.
The study results also suggest that immediate referral of all HPV positive women with mildly abnormal cytology results may be over-cautious and retesting at one year for high-risk groups and three years for the rest could be an option.
For most women, an HPV infection which they will clear naturally puts them at low risk and ‘virtually all’ cervical cancers will occur in women with a persistent type-specific HPV infection which longer screening intervals would still pick up, they concluded.
The researchers said: ‘The possibility of a small increase in risk of progression to invasive cancer between screening rounds and perhaps some increase in the proportion of women who fail to attend regularly must be weighed against the advantages for patients and reduction of NHS costs with longer screening intervals.’
It follows a study published in February in the BMJ which showed cervical cancer screenings could be safely extended to at least five years now that HPV testing is included.
Currently, women aged 25 to 64 in England are invited to have smear tests by their GP. This happens every three years for women aged 25 to 49 and every five years for women aged 50 to 64.
HPV as the primary screening method is intended to be in place across the whole of England by the end of this year.
But in June the Public Accounts Committee accused NHS England, the Government and Public Health England of ‘losing a grip’ on cervical cancer screening citing a 21-year low in uptake.
In March, Capita was stripped of its contract to run the cervical cancer administration with NHS England announcing the service would be brought back ‘in house’ from June with PHE launching a major campaign to boost uptake rates.
