The NHS in England could soon start routinely offering a test for HPV instead of a cervical smear as the initial screening test for cervical cancer, after experts ruled the change in approach would help to pick up cancers more effectively.
The National Screening Committee (NSC) has advised the screening programme in England ‘should adopt HPV as a primary screen test as it is a more accurate screening test’.
Under the new approach, women will only undergo cytology if they test positive for high-risk HPV, with further investigations if they have a positive cytology result. It is hoped the move will mean that overall, women will in future undergo screening less frequently over their lifetime.
The NSC also recommended the bowel cancer screening programme should introduce the newer, more accurate faecal immunohistochemical test (FIT) instead of faecal occult blood tests (FOBTs). Evidence has shown the FIT test is more accurate and increases uptake as the home testing is much simpler to carry out.
In other recommendations, the interval for screening patients with diabetes for diabetic retinopathy is to be extended from one to two years.
However, NSC experts have again ruled out a population based screening programme for prostate cancer. They said the PSA test is ‘still a poor test for prostate cancer and a more specific and sensitive test is needed’.
The changes to the bowel and cervical screening programmes have already been backed by the Government’s independent cancer taskforce, which forms the basis of NHS England’s new cancer strategy.
Sir Harpal Kumar, chief executive of Cancer Research UK and head of the taskforce, said: ‘I would urge all the governments of the UK to commit to rolling them out as quickly as possible, as Scotland has already pledged to do with the new bowel screening test FIT.’
Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said the move to screening for diabetic retinopathy every two years ‘should free up significant capacity, as well as preventing patients from unnecessary attendances’.
Dr Green added that, in light of the ruling on PSA tests, ‘I would like to see all patients having this test done on a private basis to be properly consented, which should include the specific information that the test is not recommended by the UK National Screening Committee’.