Cervical screening saves an estimated 5,000 lives a year by detecting abnormalities of the cervix early and referring women for effective treatment.
The NHS offers cervical screening to all eligible women aged 25 to 49 every 3 years and those aged 50 to 64 every 5 years.
Human papillomavirus (HPV) is a common virus transmitted through sexual contact. Some high risk sub-types of HPV (HR-HPV) are linked to the development of abnormal cells and can cause cervical cancer.
HPV testing in cervical screening
If screening results show borderline or low grade abnormal cell changes, laboratories perform a test for HR-HPV. This is known as HPV triage. If they find HR-HPV then the woman is referred to colposcopy. If HR-HPV isn’t found women can be safely returned to normal recall.
The NHS Cervical Screening Programme (NHSCSP) has now approved the 2 new tests below for use in HPV triage and test of cure screening protocols. These protocols help decide if the woman should be referred for further assessment or recalled again for routine screening in another 3 or 5 years’ time.
- BD Onclarity HPV test with SurePath samples performed on the BD Viper LT System.
- Cepheid Xpert HPV assay with ThinPrep samples performed on the Cepheid GeneXpert Dx System or GeneXpert Infinity System.
You can find details of all HPV tests currently approved for use in the NHS CSP on GOV.UK.
New guidance for laboratories providing HPV testing
The NHSCSP has also published guidance for laboratories that provide HPV testing in the programme.
This document:
- provides guidance on internal quality control and quality assessment procedures relevant to HPV testing
- was developed in response to queries and feedback from labs and local screening providers
- aims to standardise practice in this area
- reflects the standards implicit in ISO15189:2012
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4 comments
Comment by Lynne Williams posted on
The BAC has just circulate to members stating that there is an update regarding Primary HPV on 3rd July with a link to the Blog. Please could you let me know where I can find this.
Thanks
Comment by Mike Harris posted on
Hello Lynne, thank you for your message.
NHS England provided the following update, which was posted on 3 July in response to a question posted on another cervical screening blog post:
Following clinical recommendations regarding the configuration of laboratories to support the changes to the NHS Cervical Screening Programme made by the Options Appraisal Stakeholder Group, NHS England has been undertaking a series of appraisals to determine the affordability and operational deliverability of the options. Alongside this, the broader impact of any strategic pathology reforms and impact that may have on laboratory configuration for delivery of the cervical screening pathway must be considered. Therefore, NHS England intends to carry out a series of engagements with its local commissioning teams and Public Health England to ensure that any decisions on the number of laboratories and their footprint does not contradict existing strategies.
We recognise that this process is taking longer than anticipated, and hope you will appreciate that it is of upmost importance that the right decisions on these service changes are made. NHS England will be informing all stakeholders of this outcome as soon as this process is complete.
Regarding the process to commission and implement the delivery of the HPV test as the primary screening within the NHS Cervical Screening Programme, the central public health team of NHS England will be working closely with local commissioning teams to explore available options in relation to securing contracts to deliver this change in service. This may require a procurement process in order to comply with EU regulations. If so, this will be led by NHS England as the accountable organisation for the delivery of the Public Health Section 7a Agreement.
We hugely appreciate your patience and support with this process, and will keep you updated on key developments throughout the next couple of months.
Comment by Deirdre posted on
The Netherlands does not begin screening until age 30. All tests are HPV tests and a self-test kit is offered as an alternative. They offer screening 5 yearly but if negative, the tests after age 40 are spaced at 10 year intervals. Altogether, a Dutch woman can expect to get only 5 tests in her lifetime. They have some of the lowest rates for cervical cancer in the world. In the UK, HPV negative women will be expected to undergo at least 12 tests, 25-29 year olds are constantly hassled to get tested and there seems to be no shortage of money to run these "initiation" campaigns. Every year headlines criticise women for failing to adhere to the 3 year deadlines, and we are made to feel it's a crime to not be up to date with screening .
How is it that our neighbouring countries have evidence that a fraction of the tests at a fraction of the costs works just fine, and we don't?
Comment by Ruth Stubbs posted on
Thank you for your message. The UK National Screening Committee (UK NSC) regularly assesses evidence and makes <a href="https://legacyscreening.phe.org.uk/screening-recommendations.php">recommendations</a> to the 4 UK governments about population screening programmes. It completed its most recent review on cervical cancer screening in January 2016. Its recommendation on the age and frequency at which we offer screening is based on the best evidence.
Kind regards,