Women and people with a cervix across England who are overdue for cervical cancer screening will be offered home-testing kits for HPV as part of the cervical screening programme. The initiative was announced today by the Department of Health and Social Care and will feature in the upcoming NHS 10 year plan.

Cervical cancer is highly preventable through screening, however uptake of screening offered through the NHS Cervical Screening Programme has been declining. A 2023-34 report from NHS Cervical Screening Programme found that only 68.8% of 25 to 64-year-olds were screened within the recommended period of time – well below the NHS England target of 80%.

People don’t attend in-person cervical screening tests for a number of reasons – from difficulty in getting an appointment to barriers like pain and embarrassment.

Researchers at Queen Mary have been at the forefront of research into how to improve uptake of cervical cancer screening, leading research to test the feasibility and acceptability of HPV self-sampling to help NHS England make a decision on whether to include self-sampling tests as part of the NHS Cervical Screening Programme in England.

The team includes Professor Peter Sasieni, Professor of Cancer Epidemiology; Professor Jo Waller, Professor of Cancer Behavioural Science; Dr Matejka Rebolj, Senior Epidemiologist; and Dr Laura Marlow, Reader in Behavioural Science.

Queen Mary researchers were heavily involved in the YouScreen trial, the first pilot of self-sampling tests for HPV offered as part of the NHS cervical screening programme. Researchers demonstrated that self-sampling could reach millions of under-screened women across England who find it difficult to attend traditional screening - including those from diverse and underserved populations.

“I am absolutely delighted by the announcement that under-screened women will be offered HPV self-sampling kits under the new 10 Year Health Plan. Over a number of years we have shown that self-sampling kits provide a very good alternative to samples collected by a nurse for cervical screening; under-screened women, including some for whom conventional screening is almost impossible, are willing to provide self-samples; the offer of self-sampling is most likely to be taken-up when made personally by a member of the GP practice staff; and there are several combinations of device collection, transport conditions, and laboratory tests that work well for self-sampling. This really is fantastic news for women and for the NHS. We estimate that this simple change could help an additional one million people to participate in cervical screening regularly.”

Professor Jo Waller is a Professor of Cancer Behavioural Science at Queen Mary. She leads a team of behavioural science researchers whose work aims to understand acceptability and uptake of cancer screening. She and her team were heavily involved in the HPValidate study. The study was commissioned by the Department of Health and Social Care in 2021 to gather more evidence for NHS England on the accuracy and acceptability of self-screening tests for HPV.

Queen Mary researchers were commissioned to write two reports for the study: one on test accuracy to determine if self-sampling tests were as accurate as those collected in-person by a health professional and one on acceptability to determine how women felt about self-sampling and the experience of using the at-home test.

The study found that:

The HPValidate findings contributed to a widening evidence base on the use of HPV self-sampling in cervical screening.

"After 20 years of doing research on HPV self-sampling, it’s fantastic to see plans progressing for its introduction into the cervical screening programme. We know that self-sampling can make screening more acceptable and accessible for some people who don’t currently take part. It’s important that people understand they’ll need to attend for a standard speculum test if HPV is found in their self-sample; but our research suggests most people will be able to do this to ensure any positive results are acted upon, and they get treatment if needed, to prevent cancer developing. Cervical cancer is highly preventable and this latest development in the NHS moves us closer to eliminating the disease as a public health problem."