Painless smear test doubles uptake in older women

Despite half of the deaths from cervical cancer in the UK occuring in those over the age of 65, many older women have been found to ignore smear test invitations. Now, a new painless procedure to carry out screening is proving successful in improving the uptake in this demographic.

Research from King’s College London demonstrates that attendance to appointments by older women has doubled where the new test has been offered. Instead of using a painful speculum, the alternative procedure relies on a simple swab to gather sample cells from the cervix to check if they’re pre-cancerous.

Cervical cancer kills an average of 850 individuals a year, with 50 per cent of them being aged 65 or over. Many of these deaths could have been prevented had the cancer been detected through a smear test, but pain, embarrassment and a scarcity of time have been cited as reasons women avoid appointments.

The study focused on those who had previously ignored invitations to screenings, offering them two options. The first was to swab themselves at home and the second was to be swabbed in a clinic if they thought they might do the test incorrectly.

Of the 393 women who were given these two choices, 31 per cent were screened for cervical cancer within a year. When compared to the 14 per cent uptake seen in 391 older women being offered the more uncomfortable test, it’s clear that more options could help to cut deaths.

At present, the only type of smear test available on the NHS is one that uses a speculum to collect sample cells. The authors of the study hope that with more research, the swab method could be rolled out to women in the next three years, allowing the process to occur at home or in a clinic.

If this move was to go ahead, only those with high-risk human papillomavirus (HPV) strains would need to be examined using a speculum. Since experts acknowledge the fear and embarrassment associated with the instrument, the swab alternative could increase screening exponentially.

Dr Anita Wey Lim, who led the study from King’s College London, said: “This is a real concern because under-screened women are at the highest risk of getting cervical cancer.

“Self-sampling has been hailed as a game-changer for cervical screening, but the solution isn’t just about screening at home – having a doctor or nurse take a sample without a speculum gives women even more choice to feel comfortable about getting checked.”

Older women experience more pain through the use of a speculum than those who are younger, with discomfort increasing especially after the menopause. While testing at home would be more convenient for many, the reassurance of having a healthcare professional carry out the procedure in a clinic would be important for others.