I would like to inform the House that I have accepted the UK National Screening Committee’s recommendation to allow screening providers to offer self-sampling kits to under-screened individuals in the NHS cervical screening programme in England.
The NHS cervical screening programme in England provides all women and people with a cervix between the ages of 25 and 64 with the opportunity to be screened routinely to detect HPV infection or cervical abnormalities at an early, more treatable stage. The aim of the programme is to reduce the number of women who develop invasive cervical cancer and reduce the number who die from it.
Cervical screening does not test for cancer; it is a step before that helps to detect the risk of developing cervical cancer. This is because, since December 2019, the primary screen in the NHS cervical screening programme has been a test to detect high-risk HPV—hrHPV—which causes nearly all cervix cancers. A negative screen for hrHPV means that the chances of developing a cancer within five years are very small, as it can take around 10 years or more from the time hrHPV is caught to developing cervical cancer.
Research suggests that barriers to cervical screening attendance may include inaccessibility of appointments, anxiety and fear of discomfort and embarrassment, previous negative experiences of screening, cultural reasons, confidentiality concerns, and practical barriers such as time constraints and lack of transport or childcare. Currently, around three in 10 of the eligible population do not attend their cervical screening appointments. The change to the programme will allow service providers to offer these women a self-sample if they have not attended their appointment for six months or more following routine invitation. A self-sample that returns an hrHPV positive result will still require a clinical test to confirm the finding. However, trial evidence suggests that self-sampling will increase the numbers engaging with the screening programme.
It is important to note that, at this stage, the self-sample offer is being provided only to “under-screened” women —an under-screened individual is someone who is overdue for their routine cervical screening appointment by at least six months or has never attended. The reason that the offer is restricted to this group is because there is uncertainty about whether self-sampling is as good as clinician-taken sampling for those who regularly attend screening.
Self-sampling will help detect hrHPV, prevent cancer and save lives in those who currently do not access clinician-led screening. However, for those attending clinician testing, a shift to self-sampling might result in a programme that is not yet proven to be of equal efficacy. Further studies to consider whether self-sampling could be used across the whole population are being organised.
I would like to take this opportunity to thank the UK National Screening Committee for continuing to provide invaluable evidence-based expert advice on the introduction of new screening programmes and modifications to existing ones, and especially on achieving the right balance between benefit versus harms.
I would also like to pay tribute to and thank all those who work to deliver high-quality and safe screening across the country, and to encourage all those who are eligible for cervical screening to take up the offer of this lifesaving test.
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