Cervical Cancer Screening: Why Reducing the Frequency of Women’s Smears is Now Safe for Many

Reducing how many women are screened for cervical cancer is safe and should be expanded across the UK, experts say.

A study of 1.3 million women in the UK found evidence of longer intervals between cervical exams, also known as smears. It is transmitted sexually as long as a person tests negative for human papillomavirus (HPV), a very common group of viruses that are often found.

Researchers from King’s College London, the University of Manchester and the NHS analyzed data from the UK’s NHS cervical screening program.

Results published today in the British Medical Journal (BMJ) show that screenings every five years prevent as many cancers as screenings every three years because the tests used to screen the cervix are changing and becoming more accurate.

A new test introduced in 2019, known as the HPV primary screening test, is more accurate at detecting people at higher risk of developing cervical cancer.

Most people get some type of HPV during their lifetime, and almost all cervical cancers are caused by infection.

Although often harmless, sometimes abnormal cells can develop in the cervix. If these abnormal cells are not treated, they can develop into cancer.

Prior to 2019, abnormalities in cervical cells were first identified through cytology. If found, you will be tested for HPV. This examination is recommended every 3 years.

Northern Ireland still uses cytology, but cervical screening in England, Wales and Scotland now uses primary screening for HPV, as recommended by scientists.

‘Early introduction of HPV screening can prevent cancer’

Laura Flaherty with her children Alex (now 11) and Violet (age 7) (Photo: Laura Flaherty)

Laura Flaherty, above, was 31 years old when the smears revealed cervical cancer.

Just like before HPV screening was introduced in 2019, the mother of two believes the screening system could have been detected earlier or could have been prevented if the screening system had changed.

Ms Flaherty, now 35, said: I’ve made it all clear that having cancer still affects me today, but my treatment means I can’t have children anymore and the trauma still affects me.

“I’m not a scientist, but big changes can sound pretty scary, so I think it’s important that all the evidence for a decision related to screening is really and clearly communicated. For me, the priority should be to get more women and people getting cervical screenings and I’m really worried that so many people still don’t get tested.

“I think we need to make the checkup easier because many women find it uncomfortable, embarrassing, or even difficult to go to a GP. Home HPV testing is what we need to see so you can be tested at home. Awareness campaigns are also important, so remind people why tests exist and don’t ignore their invitations.”

Lead author Dr Matejka Rebolj, lead epidemiologist at King’s, said: They build on previous research showing that an interval of 5 years after the introduction of HPV testing for cervical screening is at least as safe as an interval of 3 years prior. By switching to screenings every five years, we can allow fewer screenings while preventing as many cancers as before.”

Michelle Mitchell, CEO of Cancer Research UK, which funded the study, said: It’s important to remember that screening tests are for people who have no symptoms. So, if any abnormal changes are detected, do not wait for an invitation to screen and talk to your doctor.”

Stephen Duffy, professor of cancer screenings at Queen Mary University of London, said, “These results indicate that we can be confident that a 5-year interval in negative patients screened for primary HPV screening will be at least as effective as a 3-year interval. With a cytology department at a one-year interval, perhaps more effective.”

We asked for comments from the Ministry of Health.