• Molly van der Heiden

Do-it yourself testing kits: tackling low cervical cancer screening rates at home

The coronavirus pandemic has impacted social and economic activity to the point where our society is barely recognisable. Now that Boris Johnson has given us a “roadmap” route out of it, it’s easy to think that the impacts of this disease will soon be over. However, the effects of interruption to scheduled disease screening for diseases which can be easily cured if diagnosed early have only just begun. One such disease is cervical cancer. Hence, when a trial was launched last week to test the efficacy of home testing kits for cervical cancer, it was highly exciting.

To understand why these testing kits may be so revolutionary, one needs to consider the uptake of cervical screening tests currently. Even prior to the COVID-19 pandemic, cervical screening rates were already at their lowest for two decades. About three million women across England had not had a smear test for a least three and a half years and yet, cervical cancer is the most common cancer in women and people with a cervix under 35. The feelings that women and people with a cervix experience about their vaginal health are often highly complex. There is an association of shame and fear; which is hardly surprising if you consider how little women and people with a cervix are educated about their bodies in mainstream education. In addition, we live in a society where women are consistently undervalued; feelings which are often projected onto themselves and their bodies. The charity Jo’s Cervical cancer Trust surveyed women in Britain in 2018 and found that a third said embarrassment caused them to delay the screening. Embarrassment can be for a wide range of issues including not having shaved their pubic hair, the appearance of their vagina and concerns over smell. The number of eligible women being tested has fallen every year since 2011 and therefore it is clear changes need to be made to this service to ensure that women do feel confident and comfortable attending.

To make matters worse, during the pandemic, like patients of many other specialties, these eligible women were not given the screening and treatment that they required. Many cervical screening appointments were cancelled or delayed and there is a steadily increasing backlog of tests which need to be worked through. In addition, many women still have justifiable concerns about COVID that means even more would be likely to not attend appointments. In short, the situation is beginning to look rather dire. However, perhaps this drastic situation, had led to the biggest innovation in cervical screening for decades, at home testing kits, which were today announced to being trialed.

The trial, being run by the NHS and called YouScreen, is offering 31,000 women and people with a cervix in North and East London to take a self-sample for cervical screening. The study has chosen to target London as it has one of the worst rates of cervical screening attendance in England. The YouScreen kit “allows women to take their own sample for cervical screening using a vaginal swab (like a long cotton bud). It is free, easy to use and can be taken at a time and place that is convenient. You do not need to be examined or to have an appointment. Most women find it comfortable and pain free. The sample collected will be tested for human papillomavirus (HPV) at the laboratory.” Sceptics may suggest that this will lead to missed diagnoses as women and people with a cervix will struggle to do the test correctly. However, preliminary research by the trial shows that 99% of women were able to self-sample properly. The trial is only be offered to women who are overdue their appointment, and whilst this may be for many reasons, the study could start to target those women who feel too embarrassed to attend. The study is only in its first stages, so we are unable to access the data. However, it’s definitely exciting and I, for one, looking forward to tracking its progress.

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