NHS to offer women under 50 fewer cervical screenings

Telegraph

a day ago

Millions of women will be offered NHS cervical screening less often under radical plans.
Those below the age of 50 will be called forward every five years instead of three.
The changes were announced on Tuesday by NHS England, who said they were backed by clinical evidence that just as many cancer cases would be detected.
Health chiefs said the changes would enable 'millions of women and people with a cervix in England to benefit from more personalised cervical screening' from next month.
Under the NHS screening system, which replaced smears, cells are tested for the presence of Human Papillomavirus (HPV), which causes almost all cervical cancer.
Currently, women aged 25 to 49 in England are offered such checks every three years, with screening every five years for those aged 50 to 64.
If HPV is detected, checks are repeatedly annually, with further investigations if any cell abnormalities are found. More regular screening is also offered to those with a recent history of HPV.
Under the new system, checks on those with positive results will remain as regular.
But the standard gap for those who test negative will extend from three years to five for women aged 25 to 49.
This puts it in line with the gap for older women, in a similar approach to that adopted by Australia, the Netherlands and Sweden.
Under the NHS plan, if a woman aged between 25 and 49 had a negative result, but previously had a positive test, they would still get a test three years later.
Health chiefs said the new approach was more 'personalised' than previous approaches.
Screening will also continue to be offered to trans men if they still have a cervix.
The NHS has this week rolled-out digital invitations and reminders for cervical screening via the NHS App, as part of a new 'ping and book' service to boost uptake and help save thousands of lives.
Eligible women will first receive a notification through the app to alert them to book a screening appointment, followed by a text message if the app notification is not opened. Letters will remain in place for those who need them.
DIY tests
It comes as the health service prepares to roll out DIY tests allowing women to 'self-sample' at home if the prefer.
Health officials have said such tests could be rolled out as soon as January if the move is recommended by the UK National Screening Committee.
The self-checks will allow those who do not attend appointments the option to do their own tests at home, ordering the kit on the app.
The NHS said the rollout of testing, which is far more accurate than older methods, means women will be able to safely have longer gaps between screening.
Studies have shown that if a patient tests negative for HPV they are extremely unlikely to go on to develop cervical cancer within the next decade.
Research on a pilot scheme involving 1.3 million women, led by King's College London researchers and published in the BMJ in 2022, showed that five-yearly screening is as safe as three-yearly, that the same number of cancers are found and less frequent cervical screening tests are needed.
It comes after they considered evidence, including a 2022 study of 1.3 million women in England.
Some other countries, including Wales and Scotland, have already extended the gap to five years, after it was recommended by the UK National Screening Committee in 2019.
Other countries have gone further. In Sweden, women aged 23 to 49 have checks every five years with seven year intervals for those aged 50 to 70.
In the Netherlands, women are invited for screening every five years from the age of 30.
If a woman tests HPV negative after the age of 40 the screening interval is extended to 10 years. Australia – which aims to become the first country in the world to eliminate cervical cancer – offers checks every 5 years for women aged 25 to 74.
The NHS in England has urged women to come forward for cervical screening, with latest figures showing more than 5 million are not up to date with check-ups.
Dr Sue Mann, the NHS's national clinical director for women's health, said: 'Taking a more personalised approach to cervical screening will help ensure everyone eligible can make the most of these life-saving services, while sparing them appointments that they don't need.
'The NHS is following robust evidence on how often women need to be safely screened, and by putting invitations and reminders straight in women's pockets on their phones, we're making it easier than ever to take up screening appointments.
'Make sure you come forward for your screening when you're invited, even if it was weeks, months or years ago. If you think you are due but have not yet had an invitation, speak to your GP practice.'
For decades, the NHS offered smear tests, which checked cervical cells for abnormalities. If abnormalities were found samples were tested for HPV.
But since 2019, the system has been changed so the tests check for HPV in the first instance.
Cell abnormalities
As HPV infection comes before cell abnormalities develop, the new system has been found to be more accurate and to detect more women who may be at risk.
NHS officials have pledged to eliminate cervical cancer by 2040.
Michelle Mitchell, the chief executive of Cancer Research UK, said: 'We welcome this change to cervical screening in England, which is the result of years of vital research to make screening more effective and has shown it is safe to extend the time between tests.
'Screening, alongside the roll out of the HPV vaccine – which Cancer Research UK scientists helped develop – have seen cervical cancer rates drop by around a quarter since the early 1990s, and we look forward to even more progress.'
Athena Lamnisos, the chief executive of The Eve Appeal, a cancer charity, said: 'Every single case of cancer that can be prevented, should be, and this new guidance is good news for those at low risk because they will no longer need to go for cervical screening as often.'