Research shows demand for choice in cervical screening

Most women would welcome the choice between self-sampling and traditional screening in human papillomavirus (HPV)-based cervical screening, a study suggests. 

HPV is a common virus transmitted through sexual contact and is the primary cause of cervical cancer, responsible for over 99 per cent of cases.

Researchers assessed a group of 2,300 women aged 24-65 who had collected their own samples alongside having their standard cervical screening in 38 GP practices across 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.

Of the women surveyed, 85 per cent preferred being given the choice, with 72 per cent stating this choice would enhance their screening experience, and 69 per cent said they would choose to self-sample at home if offered a choice in the future.

However, a proportion of women expressed concern about making the choice between screening methods: 23 per cent felt it would be difficult to choose, 15 per cent would worry about making a choice, and 48 per cent would prefer a recommendation. These concerns were reported more frequently by women with fewer qualifications, compared to women with degree-level education.

Researchers believe these 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.

Senior author Jo Waller, of Queen Mary University of London’s Wolfson Institute for Population Health, 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.”

First author Dr Laura Marlow added: “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”.

Cervical cancer is one of the most preventable types of cancer. However, data show that 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 between 25–64 are not up to date on 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.