A new study led by researchers at Queen Mary University of London reveals women would welcome the option to choose between self-sampling and traditional screening done by a nurse or doctor for human papillomavirus (HPV)-based cervical screening.
The study, published in the Journal of Medical Screening, 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% preferred being given the choice, with 72% stating this choice would enhance their screening experience, and 69% 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% felt it would be difficult to choose, 15% would worry about making a choice, and 48% 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 in the UK and beyond.
Senior author, Jo Waller, Professor of Cancer Behavioural Science, Centre for Cancer Screening, Prevention and Early Diagnosis at 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".
Dr Laura Marlow, Senior Research Fellow at Queen Mary University of London, and the study's first author said: "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".
Public Health Minister, Andrew Gwynne said: "We know the earlier cancer is caught, the easier it is to treat, so it's crucial that access to screening and tests is made as simple as possible.
"I welcome this research and the government is working closely with the UK National Screening Committee to explore the potential of self-sampling."
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.
This study was funded by the Department of Health and Social Care (DHSC).
