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Cervical screening intervals could be safely extended to at least five years

Cervical cancer screenings could be safely extended to at least five years following a switch to HPV tests, according to a new study.

Researchers compared HPV screening with traditional cytology (smear) testing and found it to be ‘more sensitive’.

The findings, published in the BMJ, also reported that HPV screening offered ‘greater protection against cervical cancer’ and could be conducted every five years ‘without increasing the risk of potentially life-threatening disease’.

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.

Clinical trials have shown HPV screening leads to earlier detection of cervical lesions, compared to liquid based smear tests, and as such NHS England and Public Health England have pledged to rollout HPV screening by the end of 2019.

The latest study, which tested out the trial results, was conducted in six NHS laboratories across England.

A team of UK researchers analysed results from 578,547 women aged 24-64 years undergoing routine cervical screening (32% HPV; 68% cytology) between May 2013 and December 2014, who were followed up until May 2017.

The research team compared levels of cervical lesions picked up by the two screening tests and found that HPV screening detected ‘substantially more’ lesions than cytology testing, up to 50% for some grades.

The report concluded: ‘In addition, this increased detection in prevalence (existing cases) was followed by a marked reduction in incidence (new cases) after three years, lending strong support to an extension of the screening intervals’.

Currently cervical screening is offered every three years to women aged 25 to 49 in England, and every five years to those aged 50 to 64. Each year 2,500 cases of cervical cancer are diagnosed in England, with a quarter diagnosed after a ‘normal’ smear test result.

Reducing the screening to five year intervals could potentially reduce GP workload although this may be counteracted by a measure currently under review to increase the upper age limit to 75.

The UK National Screening Committee is reviewing the findings of a previous study published in The Lancet Oncology, which found that increasing the age of cytology screening to 75 years led to incremental decreases in cancer risk later in life.

Earlier this week, Pulse reported GP databases used for health screening programmes, including cervical cancer, were not ‘fit for purpose’ and targets to screen eligible women were not being met.


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