'NHS should adopt cervical self-screening as option for all women in England' says new report
'NHS should adopt cervical self-screening as option for all women in England' says new report
Healthwatch England report polled 2,400 women who were hesitant about cervical screening
The NHS is being urged to adopt cervical self-screening as an alternative option offered to all women in England who would prefer it.
Healthwatch England, a statutory committee of the independent regulator the Care Quality Commission (CQC), issued the recommendation as part of a new report ‘Cervical screening, my way’ which explores women’s attitudes and solutions to improve uptake of cervical screening.
Declining rates of cervical screening
Cervical screening is an important part of preventing cervical cancer as it can detect the Human Papillomavirus (HPV) - a prevalent, often symptomless virus linked to cervical cancer.
But despite its importance, rates of cervical screening have declined in England over the past 20 years. Between 31 March 2022 and 31 March 2023 just over two-thirds (68.7%) of eligible women were screened, below the national target of 80% and the lowest since 2014 when coverage stood at 74.2%.
In a poll of more than 2,400 women who were hesitant about cervical screening, Healthwatch England found in its report that the top reasons for hesitancy among respondents were worries about physical discomfort, embarrassment at undressing in front of healthcare professionals and a belief they didn't have to go because they weren't currently sexually active.
Strong support for home testing
While those surveyed were hesitant about cervical screening, the report found strong support (73%) for home testing – currently being considered as an option by screening experts.
Benefits cited included privacy, avoiding discomfort, convenience and a past negative experience with traditional screening.
A caveat from respondents is that they would use home testing if it was offered free on the NHS. Of note, 96% of respondents said they’d never bought a home testing kit, which is sold online for between £29 and £129.
As a result, Healthwatch England has recommended the adoption of self-screening as one of six recommendations made in the report. It says self-screening could be an alternative option offered to all women nationally who would prefer it and subject to the results of NHS-commissioned research on the safety and effectiveness of self-screening.
Research in the NHS has already begun on this. Under a pilot study called YouScreen, which ran in 2021, 31,000 women in London who were at least six months overdue for their latest cervical screening appointment were sent home testing kits directly or invited to take part by their GP surgery. Women received instructions and a link to a video showing them what to do. Around 8,000 people took part.
Results published in July 2024, showed 8,838 people sent back self-samples; 64% of who were from ethnic minority groups and 60% from deprived populations. More people (56%) returned a kit when it was offered to them by their GP practice than when it was mailed directly to them (13%).
Policymakers should act
Other recommendations in the report include a call for more inclusive reporting (to better include disability and ethnicity data) and for NHS England to address the gap left by the closure of Jo’s Cervical Cancer Trust (the only charity and national helpline solely dedicated to cervical cancer).
The report also requests better training for screening providers to ensure they can meet responsibilities regarding accessible information and adjustments to care.