Exclusive Colposcopy services are set to be inundated with GP referrals as a result of HPV testing being added to the NHS cervical cancer screening programme, with a Department of Health GP adviser predicting a 60% spike in demand.
Dr Jane Woyka, a member of the newly formed DH HPV Pilot Implementation Group and a GP in Harrow, west London, told Pulse adding the test would reduce GP workload but could lead to backlogs in processing patients with the diagnostic service likely to be ‘overwhelmed’.
It comes as the first evaluation of pilots where HPV testing was added to cervical screening – published in the British Journal of Cancer – found the number of women going for further unnecessary tests was cut by a third.
The study by the Institute of Cancer Research looked at more than 10,000 women aged 25-64 who were part of the NHS Cervical Screening Programme and whose first smear test had shown mild or borderline abnormalities in the cervix. These cervical screening samples were then tested for HPV, with 3,581 women (35%) found to be HPV negative and returned to routine screening.
Professor Julietta Patnick, director of the NHS Cancer Screening Programme, said she was ‘very pleased’ with the results of the pilots.
‘By incorporating HPV testing into our current screening programme in this way,we will be able to significantly reduce the number of repeat cytology tests required and to target our colposcopy services more effectively,’ she said.
The inclusion of HPV testing in the cervical cancer screening programme was due to be expanded beyond the six pilot sites in April, although Pulse revealed in May that the rollout had been hit by delays and the programme now hopes it was be completed ‘within the next year’.
Dr Woyka, who spent ten years on the DH Advisory Committee on Cervical Screening, warned that the extra demand for diagnostics would stretch colposcopy services to the limit.
‘There will increased workload to start with as the colposcopy service will get more referrals because the borderline cases will be sent to them directly so that will be a big challenge. There will be big issues for the service that could be overwhelmed as there will be an increase of at least 60%, which is huge.’
But GP workload would be cut, she added: ‘This will impact a lot on our management of borderline results.The amount of work and the amount of patient anxiety will be significantly reduced.’
What is changing?
How it works currently
Women with a borderline test result are recalled every six months, up to three times, and on the third occasion are sent for a colposcopy
Under the new system
Borderline test results prompt an HPV test and if positive, patients are referred directly to coploscopy. If negative the patient returns to a normall cal and recall.