Policy briefing

How to advise women about the new cervical screening test

Hundreds more lives in the UK could be saved with the introduction of a more sensitive cervical screening test, which can spot infections earlier

Hundreds more lives in the UK could be saved with the introduction of a more sensitive cervical screening test, which can spot infections earlier

Picture shows computer artwork of human papilloma virus particles in the bloodstream. A more sensitive cervical screening test rolled out across the UK means infections will be spotted earlier
Computer artwork of human papilloma virus particles in the bloodstream
Picture: Science Photo Library

Essential information

There are 2,500 new cases of cervical cancer in England every year, mainly affecting sexually active women aged 30-45. Almost all cases of cervical cancer are caused by the human papilloma virus (HPV), a common virus that can be passed on through any type of sexual contact.

There are more than 100 types of HPV, many of which are harmless, but 14 types can cause cervical cancer as well as some head and neck cancers. Over the past ten years there has been a worrying decline in the number of women taking up offers of cervical screening, according to the charity Jo’s Cervical Cancer Trust.

What’s new?

Hundreds more lives could be saved every year thanks to a more sensitive cervical screening test that has been rolled out across the UK.

NHS experts say there is the potential to eliminate cervical cancer in England thanks to changes in primary testing in the NHS Cervical Cancer Screening Programme, combined with the effectiveness of the HPV vaccine.

The new and more sensitive test, which is now available across England and Wales, looks for traces of high-risk HPV, which causes nearly all cases of cervical cancer. Any tests that are HPV positive lead to the sample being checked again for abnormal changes in the cervix.

This primary screening approach means that any sign of infection will be spotted at an earlier stage, before it can potentially develop into cancer, according to NHS England.

If someone has a high-risk HPV but no abnormal changes in the cells of the cervix, they will be asked to come back for another cervical screening in a year’s time. The body generally clears HPV and there is no treatment for the virus, but if it is still present they will be invited back for a further year. If it is still present after three years, a colposcopy will be offered.

The early stages of cervical cancer often cause no symptoms, making screening one of the most effective ways to protect against the disease. Combined with the success of the HPV vaccine for boys and girls, NHS England says that cervical cancer could be eliminated altogether.

The vaccine programme for girls began in 2008. Since then, the incidence of some types of HPV (HPV 16 and 18) infection in females aged 16-21 has fallen by 86% in England.

Scotland plans to introduce primary screening in March, while Northern Ireland also plans to make the change in the future, Jo’s Cervical Cancer Trust says.

Expert comment

Picture of Imogen Pinnell, health information manager at Jo’s Cervical Cancer Trust. A more sensitive cervical screening test tha has been rolled out across the UK means infections will be spotted earlier.Imogen Pinnell, health information manager at Jo’s Cervical Cancer Trust

‘This move to primary screening in England and Wales is incredibly positive, as it is so much more sensitive and can potentially save several hundreds of lives more than the old system of testing. For patients and practice nurses, collecting the sample is no different, it is just tested in a different way.

‘The key difference for practice nurses is providing advice and reassurance for women about high-risk HPV, and what it means if a woman receives a positive test. Women can be particularly anxious coming back for the yearly screening checks if they have high-risk HPV and no cell changes, so they need clear advice and information.

‘I would encourage practice nurses to stay up-to-date with the latest information about HPV and cervical smears so they know the best answers to women’s questions. The NHS e-learning tool is a good place to start.’

How you can help your patient

There is a lot of confusion and fear around HPV. Healthcare professionals can play an important role in reducing myths and stigma, and helping people understand the virus better:

  • Be mindful of the language you use. It is unhelpful to link HPV to promiscuity and sexual behaviour, including calling it an STI or STD. Unlike many STIs, HPV cannot be treated or fully prevented and is not always detectable. You could say something like: ‘HPV is a common virus that most of us get at some point in our lives.’
  • Be prepared for difficult questions, especially ones where there is no right or wrong answer, such as whether to tell sexual partners.
  • Offer reassurance about HPV. This is a good chance to address HPV myths and stigma, especially around shame, cheating and sexual behaviour. Giving people the facts about HPV can help them to understand that in most cases the virus will just go away on its own.

Source: Jo’s Cervical Cancer Trust – Talking about HPV, a guide for healthcare professionals


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