Could self-testing kits save women?

This year marks the 10th anniversary since the death of Big Brother celebrity Jade Goody, who passed away from cervical cancer. Despite the publicity surrounding Goody’s death in 2009, cervical cancer screening attendance is at a 21 year low and preventable deaths are still occurring across the UK. However, new approaches to boost attendance are being discussed by the UK screening programme, including a new cervical cancer self-sampling kit which allows women to collect the sample in the privacy of their own home.  

Every year, it is estimated that more than 800 women die from cervical cancer in the UK. Almost all cervical cancer cases are caused by Human papilloma virus (HPV), a sexually transmitted infection. What starts as an abnormal growth of cells along the cervix can become cancerous and can kill if left ignored and untreated.

Attending a test

When a woman attends for a cervical smear test, a nurse or GP takes a sample of cervical cells which is sent to a hospital laboratory. It is then examined by biomedical scientists and laboratory staff who look for abnormalities.  If caught in time, it is estimated that more than 99% of all cervical cancer deaths are preventable.

However, smear tests are often perceived as invasive and uncomfortable and fewer young women are turning up to their routine examinations. In 2018, only 71.4% of women in England attended their appointments. Whilst in Scotland, the figures show a similar story as only 72.8% of women attended their routine tests in 2017/18.

Self-sampling kits

To try and address the decline in screening rates, NHS Scotland is proposing an innovative pilot study through the use of self-sampling kits. The kits will be sent to women who haven’t responded to their cervical screening invitations.

Allan Wilson, President-Elect of the Institute of Biomedical Science and Advanced Practitioner in cervical cytology at Monklands Hospital, commented,

“In recent years there’s been an increase in incidence of cervical cancer and deaths, particularly among younger women, which is worrying.  There is UK and international evidence indicating that a third of the women who were not showing up for appointments but were sent the kits have used them, so we’ve got another cohort of women into the screening programme.

If the sampling kit is successful for women who have not engaged with the screening programme there is a possibility that this could be offered to all women. Screening programmes in other European countries are already considering this option."

The samples taken by the self-sampling kits have the advantage of being suitable for automated HPV testing, which could decrease the waiting times for patient results to within 2 days - but there are drawbacks.

Kirstie Rice, Consultant Biomedical Scientist in cervical cytology at New Cross Hospital and a specialist advisor for the Cytopathology Panel at the Institute of Biomedical Science, explained,

“The self-sampling kits only detect HPV. They’re not necessarily as useful as a normal cervical screening test as you could get a false negative result and the sample could be compromised. It’s not foolproof. But if a woman isn’t testing at all, then the tests are useful.”

Turning to technology

In other efforts to increase attendance, NHS Trusts and doctors’ surgeries are turning to technology. Registered female patients are now also reminded to get tested via text message and email. Meanwhile, more support networks are also available to young women.

Charities like Jo’s Cervical Cancer Trust are offering encouragement and advice so that more young women will attend. It is hoped that, in the years to come, this mixture of self-testing and digital outreach will help to reduce the number of needless deaths.