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a hpv vaccine imageNovember 15 2017

The human papilloma virus vaccine could reduce to three the number of times a woman needs to undergo cervical screening during her lifetime.

A study has found that three screens at 30, 40 and 55 would offer the same benefit to vaccinated women as the 12 lifetime screens currently offered in England. The researchers have based their conclusions on how the HPV vaccine and the improved cervical screening programme will work best together.

Cancer Research UK supported the study conducted at Queen Mary University of London (QMUL). It said: “The new programme called HPV primary testing is set to be introduced in England by December 2019. It means that cervical samples are tested for HPV but only checked for abnormal cells if the virus is found. The current test checks for abnormalities first, which is less efficient. Scotland and Wales are also preparing their own plans to introduce this new HPV test.”

In addition, the new screening method could also mean a reduction in the number of times unvaccinated women would require cervical screening to seven.

Professor Peter Sasieni, Cancer Research UK’s screening expert and lead author based at QMUL, said: “The NHS should benefit from the investment that it’s made by introducing the vaccination programme. These women are far less likely to develop cervical cancer so they don’t need such stringent routine checking as those at a higher risk.

“This decision would free up resources for where they are needed most. The change in the screening system is a unique opportunity to reassess how often women are invited for cervical screens during their lifetimes.”

The study’s publication follows the release earlier this month of new data indicating that fewer women are attending for cervical screening. Public Health England is particularly concerned about younger women not attending.

“NHS Digital statistics show a drop in the number of women of all ages being screened but worryingly only 62% of younger women took up the invitation for a test last year. PHE is urging all eligible women (aged 25 to 64) who are invited for cervical screening (smear tests) to take the test,” it said.

NHS Digital’s report, ‘Cervical Screening Programme, England - 2016-17’ says that coverage for women aged 25 to 64 was 72.0% as at March 31 2017, down from 72.7% in 2016 and from 75.7% in 2011, when collection of age appropriate coverage began.

As at 31 March 2017:

  • coverage for women aged 25 to 49 was 69.6%, compared to 70.2% in 2016;
  • for women aged 50 to 64, coverage was 77.2%, a decline from 78.0% in 2016;
  • at a regional level, coverage of the full target group (ages 25 to 64) ranged from 65.7% in London to 75.4% in the East Midlands;
  • all regions reported a fall in coverage when compared with 2016.

The report adds that 4.45 million women were invited for screening in 2016-17, a 5.6% increase from 2015-16, when 4.21 million women were invited. The number of women tested in 2016-17 was 3.18 million, up 2.9% compared to 2015-16, when 3.09 million women were tested.

Sophia Lowes, Cancer Research UK’s health information officer, said the figures were disappointing. “Cervical screening aims pick up abnormal cells before cancer has a chance to develop so we’d encourage women to think about taking part when they receive their invitation,” she said.

Links:
CRUK announcement HPV jab     
R Landy et al. What cervical screening is appropriate for women who have been vaccinated against high risk HPV? a simulation study.  Int. J. Cancer. Published online November 10 2017. doi:10.1002/ijc.31094       
CRUK blog: ‘The HPV vaccine and cervical screening: how many tests do you need?’           
PHE announcement        
NHS Digital Cervical screening report information              
NHS Digital ‘Cervical Screening Programme, England - 2016-17’  
NHS Digital cervical screening interactive resource for primary care and CCGs       
CRUK comment on cervical screening data

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