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HPV triage pilot ‘will save the NHS millions’

The inclusion of HPV testing in the cervical screening programme will be run at a local level and save £16 million a year, according to a pilot study.

Currently women who show borderline cervical changes or mild dyskaryosis after a cervical smear are submitted to a follow up process of screening which can result in women waiting a year for a colposcopy referral.

Also, women who undergo a colposcopy and are subsequently treated for cervical intraepithelial neoplasia are screened annually for the next 10 years. But the pilot found the use of HPV testing can rule out CIN in a third of these women. 

But the move to include HPV testing would divide both groups into high and low risk of getting the virus, which is present in 99% of cervical cancers.

A Department of Health report on the pilot study in six sentinel sites, the findings of which were published this month, sets out how the national programme will begin.

HPV testing will be done at a local level, with existing screening services expected to process at least 35,000 samples each year, and deliver test results within 14 days.

GP commissioners will also need to identify a care pathway and select a HPV testing kit from an approved list.

The report also outlined the reduction in waiting times for patients and cost of repeat cytology screenings, with the DH estimating a saving of £16 million would be made each year by the third year of the roll out.

NHS Cancer Screening Programmes has announced that £2 per sample in the first year and £1 per sample in year two.

The drop in funding is based on predictions that initial colposcopy referrals will be higher in the first year, when both old and new screening systems will still overlap.

Jean King, a director of policy at Cancer Research UK, said:  'We welcome the introduction of HPV testing for women with mild or borderline cervical screening results and of using the HPV test to tell whether women who have been treated for cervical abnormalities have been cured. Avoiding unnecessary recall and treatment will benefit women while making significant savings to the NHS over time.'

'But the start up costs and logistics should not be underestimated. We hope that local services – who are already responsible for implementing other major changes – can introduce the new protocols smoothly within the budget provided and to the high quality expected of the screening programme.'


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