Clinical update

Cervical cancer: how the NHS at-home HPV testing trial is being rolled out

Cervix home HPV testing kits will help address shortfall in screening attendance

The human papillomavirus (HPV) is a major cause of the main types of cervical cancer and home HPV testing kits are now being introduced to address shortfalls in screening attendance

Essential facts

There are around 3,200 new cervical cancer cases in the UK every year, the equivalent of more than eight every day, according to Cancer Research UK (CRUK) .

The human papillomavirus (HPV), which most sexually active people will come into contact with in their lifetime, is a major cause of the

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The human papillomavirus (HPV) is a major cause of the main types of cervical cancer and home HPV testing kits are now being introduced to address shortfalls in screening attendance

Light micrograph of a cervical smear revealing epithelial cells infected with the human papillomavirus
Light micrograph of a cervical smear revealing epithelial cells infected with the human papillomavirus Picture: SPL

Essential facts

There are around 3,200 new cervical cancer cases in the UK every year, the equivalent of more than eight every day, according to Cancer Research UK (CRUK).

The human papillomavirus (HPV), which most sexually active people will come into contact with in their lifetime, is a major cause of the main types of cervical cancer.

HPV is common and lives on the skin, so it is easy to contract and difficult to prevent. Most people will become infected at some point in their lives, but in 90% of cases the virus will resolve naturally within two years.

Some 12 types of HPV are considered high-risk for cancer of the cervix. Two of these types (HPV 16 and HPV 18) cause about seven out of ten (70%) cervical cancer cases, according to CRUK.

What’s new?

In February, NHS England announced that for the first time it will be offering more than 31,000 women and people with a cervix home HPV testing kits.

The YouScreen swab kits are being distributed via 166 general practices as part of the trial running until December by Public Health England, NHS Digital and King’s College London.

Kits will be sent out to those aged 25-64 years who are 15 months overdue for cervical screening and live in the London boroughs of Barnet, Camden, Islington, Newham and Tower Hamlets, where screening appointment attendance is low.

In addition, general practice nurses and healthcare assistants in participating practices are also being trained to offer the kits opportunistically to those whose tests are overdue.

Once complete, participants can post their test directly to the NHS Cervical Screening Programme’s London laboratory, with results sent to themselves as well as their GP surgery. If HPV is detected, patients will be invited to attend their GP for cervical screening.

Key points for nurses

As part of the trial, participants can watch a YouScreen test video explaining how to do the test at home. This makes it clear that the test is screening for HPV, which does not entail having to touch the cervix.

YouScreen test kits include a plastic tube containing a swab, which the person inserts into their vagina, up to the red mark on the stick, rotating gently for 20 seconds before replacing it in the plastic tube. Nurses should reassure their patients that research shows 99 of 100 women are able to do self-sampling effectively and it should not be painful.

Nurses can play a key role in enabling patients to understand more about HPV and helping to eradicate some of the confusion and stigma that surrounds it. A 2020 survey of more than 2,000 women conducted on behalf of Jo’s Cervical Cancer Trust found that one quarter of respondents had not heard of HPV, and nearly half were unclear about its connection to cervical screening.

Expert comment

 Kate Sanger, head of policy and communications at Jo’s Cervical Cancer Trust

Kate Sanger is head of policy and communications at Jo’s Cervical Cancer Trust, and a member of the study’s steering group

‘As an organisation, we’re supportive of this home-test initiative and it’s something we’ve been calling for at Jo’s Cervical Cancer Trust for a long time. But there’s a lot of work to make sure that a change in a national programme is: suitable; safe; is what women want; and works in practice with all of those involved.

‘We know other countries have human papillomavirus self-sampling as part of their screening programmes and they’ve seen great results in term of reaching non-attenders, increasing uptake generally and reducing inequalities in access.

‘There is great demand for it, especially among those who find attending screening harder. This includes those with health conditions who find it uncomfortable; women who have experienced trauma or sexual violence; those with physical disabilities; women who are struggling with time and others.

‘Although there is a need for more research, we would love to see the home-testing kit rolled out across the UK as a choice of how you can access screening.’


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