Cervical screening is one of the most successful public health interventions of our era. For decades, women (and other people with a cervix) in the UK have been invited to book an appointment with a trained clinician, who collected a sample of cells from the mucosa of the cervix uteri (a so-called "smear test"). Samples were evaluated in a laboratory, and if cellular abnormalities were confirmed the woman was offered treatment. Treatment of screen-detected precancerous lesions has been shown to prevent cervical cancer and, in England alone, around 2000 premature deaths each year.
Since 2019, cervical samples have been evaluated in laboratories for the presence of human papillomavirus (HPV). In the UK and abroad, testing for HPV has been demonstrated to be more effective in preventing cervical cancer than smear tests. A further advantage of HPV testing over smear tests is that the virus is detectable in self-collected vaginal samples, which do not require the involvement of a trained clinician. There is increasing international interest in using vaginal self-collection methods to increase the acceptability of cervical screening, and particularly to engage eligible participants, who are currently under-screened.
Researchers from the Wolfson Institute of Population Health at Queen Mary University of London (QMUL) are involved in various studies to determine how HPV self-collection could be implemented in routine screening programmes in the most effective and acceptable manner.
One of those studies, HPValidate, was set up in 2021 to establish the accuracy of self-collected vaginal samples for identifying HPV infection. The work was designed to inform decisions about the possible future use of HPV self-collected samples in the NHS Cervical Screening Programme in England. QMUL researchers led a study of test accuracy (compared with samples collected by a health professional), and a nested study of user acceptability. Findings on attitudes towards being offered a choice of self-collection or standard clinician screening are published here. Findings on test accuracy are currently undergoing peer-review.