Results from a WIPH-led study reveal that 85% of women would welcome the option to choose between self-sampling and traditional screening performed by a clinician for human papillomavirus (HPV)-based cervical screening.
The study surveyed 2300 women aged 24-65 who collected their own samples alongside having standard cervical screening in 38 GP practices in England. Participants were asked about their screening preference, and their attitudes toward being offered a choice between the two methods. Researchers explored age, education, ethnicity, and screening experience as predictors of attitudes towards a choice and anticipated future choice.
Results showed that 85% of women preferred being given the choice, with 72% stating that this choice would enhance their screening experience, and 69% saying that they would choose to self-sample at home if offered a choice in the future. Some women expressed concern about making the choice between screening methods: 23% felt it would be difficult to choose, 15% would worry about making a choice, and 48% would prefer a recommendation. These concerns were reported more frequently by women with fewer qualifications compared with women educated to degree-level.
Researchers say that their findings highlight an urgent need to explore and evaluate different methods of offering this choice, ensuring that effective messaging is used during any implementation or assessment of HPV self-sampling options in the UK and beyond.
Although cervical cancer is one of the most preventable cancers, uptake of in-person screening offered through the NHS Cervical Screening Programme is at an all-time low in England. In 2023, data from NHS England showed that about one in three eligible women aged 25-64 were not up to date with their cervical cancer screening. This study comes as more flexible screening methods such as self-testing are being explored to increase participation and make the screening service more accessible for women. Data reported in this publication were collected as part of a survey commissioned by the DHSC.
Senior author Jo Waller said: ‘This study confirms that choice would generally be welcomed when it comes to cervical screening. For many, self-sampling would be a more convenient and acceptable option, but others prefer the reassurance of knowing a nurse or doctor has done the test.’
Study first author Laura Marlow told us: ‘It was striking that a significant number of our participants said they would like a recommendation. We need to keep this in mind when thinking about how best to make self-sampling available, to make sure that having to make a choice doesn’t become an additional worry or burden, and to avoid exacerbating social inequalities in screening uptake.’
Public Health Minister Andrew Gwynne said: ‘We know the earlier cancer is caught, the easier it is to treat, so it’s crucial that access to screening and tests is made as simple as possible. I welcome this research, and the government is working closely with the UK National Screening Committee to explore the potential of self-sampling.’
Marlow L, Drysdale H, Waller J. Attitudes towards being offered a choice of self-sampling or clinician -sampling for cervical screening: A cross-sectional survey of women taking part in a clinical validation of HPV self-collection devices. Journal of Medical Screening. 10 October 2024. DOI: 10.1177/09691413241283356
https://doi.org/10.1177/09691413241283356