The NHS is so slow at innovation.

[Meixo]

I'm doing a literature review the joys. To my utter dismay many other countries are offering home HPV testing within their cervical screening programmes. There's lots of literature out there from high income countries with successful trials. The WHO is recommending this as an option it has very similar accuracy to HCP testing. Our screening programme still only offers a test with the bloody speculum.

I had CIN 3, I'm still waiting for test of cure which means I will have to go and have the smear. I can pay £40 for a private hpv test but it won't be integrated into the NHS system. 99.7percent of cervical cancers are caused by hpv infections, women should not have to have an intimate examination as the only option. There are so many women who would hugely benefit from these . They are currently doing a couple of trials which will take an age to validate then the rollout will take forever.

Why is this? The WHO recommends its so much cheaper for the NHS than HCPs doing the test. Other trusted high income countries are implementing this. Why are we stuck in the dark ages? I'm really resenting the fact you cannot have a NHS HPV test without someone sticking a speculum up your fanny. I imagine if this was a male issue it would be implemented a lot quicker.

What's with the high-income countries malarkey?

You are just advertising here, classic pharmaceutical technique to rustle up demand for your product

There was a trial of this in 2021 and a charity funded offering in Yorkshire for women over 65 to do a home test as the regular smear tests for that age group had been stopped.

I had a search but couldn't find any info on the results of the initial trial. It does seem mad that the NHS aren't pushing for these tests as it seems fairly obvious to me at least that it would increase screening uptake.

I really wish I was a pharmaceutical company, I might have power to change things. High income countries means comparable healthcare systems surely there doesn't need to be numerous clinical trials if other countries are having great success. I'm dismayed that we don't have the choice yet, it would increase screening uptake and comfort for so many women.

When I had smear test last year the nurse said NHS does have plans to bring home tests in, instead. Home-tests for all sorts of infections are all the rage.

I imagine in-person smear tests will still be offered for people who can't do the home-tests, though. Best of both.

I had some great advice from nurse, even though I'd seen 2 other HCPs about my issues who also did intimate physical exams, the nurse who was "only" doing the smear test part, is the one who actually diagnosed me correctly (I reckon). There's a lot to be said for "experience".

There was another thread about smear tests where I said considering they are only checking for HPV now wouldn't it make more sense for them to just swab (or send out home swabs) so it is less degrading to women and more likely that women will participate if they don't need a full smear. I was shot down and told that the smear is so the nurse can visually check your cervix as they might spot changes/cancer...

I still however think home swabs would be a much better use of time, resources and mean more women would participate.

It'll be on it's way.

My last smear test was Feb 22 and I was invited to take part in the research leading towards home testing. I still had to go in to the GP but did the test myself with a home kit.

@CaputDraconis agree with you.

Not one study that I’ve read re self-sampling raises the problem of not having someone visually inspecting the cervix, nor have cancer charities raised this as a potential issue. Studies also show an increased rate of participation of around 10% when self-sampling is offered.

I use Check4Cancer tests at home and send the results to my GP and this information is recorded in my files. If I had high risk HPV I would book a cervical screening test at my surgery.

More importantly, I suppose, my GP doesn’t have a problem with this.

The people who are underscreened are more likely to be in deprived areas, disabled , have MH issues, cultural differences , less than one third of women with a learning disability are currently screened but are at more risk of being sexually abused. Many would not be able to afford £50 or know they could get a private test. Persistant HPV infection causes 99.7 percent of cervical cancers.

A cervical screening is to test for HPV and take a sample it's not done to look at the cervix which is just a visual inspection. Obviously if you had issues post coital bleeding , bleeding between periods a colposcopy is more useful as it can look at the cervix in detail. There's no reason to have an invasive examination for a HPV test. Some women might want to that's fine , they should still be able too but for those that don't a self sampled HPV test should be offered. It's estimated at least 50percent of women will choose to self sample when given the information.

It's also cheaper screening costs the NHS 175 million you could cut costs by 40 or so million if a significant proportion choose to self sample.

@Meixo absolutely agree, which is why self-sampling kits should be available via the NHS. It attracts a higher uptake, is less expensive, and can be carried out at a time convenient to the woman.

The point I was making is that my NHS GP is more than happy to accept and record the results of my HPV screening ergo she believes it is as valid a test as the Pap smear carried out in the surgery.