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HPV test ‘slashes number of cervical smears needed’

By Lilian Anekwe

Adding HPV testing into the cervical screening programme could – with HPV vaccination – dramatically scale back the screening programme, cutting the number of smears women need in their lifetime from around 12 to just two.

HPV testing is currently used alongside cervical screening in a handful of testing sites in England, and only to detect mild dyskaryosis or triage of other borderline changes in cervical cells, and for post-treatment surveillance.

But data from a modelling study funded by Cancer Research UK – presented at last week’s National Cancer Research Institute conference in Liverpool – suggests routinely testing for the virus would mean women receiving the HPV vaccine aged 11 to 14 could have one test at age 30 and another at 45 (see box).

The data was presented by Professor Peter Sasieni, a Cancer Research UK scientist at Queen Mary University of London and a member of the Department of Health’s advisory committee on cervical cancer.

He said he would urge ministers to stop ‘procrastinating’ and begin to rollout the HPV test as the primary means of screening women for cervical cancer in England.

‘It’s not clear what further research one would want and I don’t see the point in procrastinating any more. With all the tests showing that if you screen with HPV testing and you look three years later you find far less [of the more severe] CIN2 and CIN3-grade cell changes in the women screened with HPV compared with women screened with cytology, the general shift of opinion has happened in the majority of people and they now think it’s the right thing to do,’ he said.

Cytology based screening has played a major role in preventing cervical cancer, he added, but is expensive, requires extensive quality assurance measures and is less reliable than HPV DNA testing.

‘I’m convinced it’s time to start rolling it out. It’s not unreasonable to say that within five years the whole country should have switched.’

DH adviser urges move away from cytology for cervical cancer screening