NHS England Extends Cervical Screening to 5 Years for Many

From July, women in England aged 25-49 who test negative for human papillomavirus (HPV) will be invited for cervical screening every 5 years instead of every 3 years. 

NHS England said the updated screening schedule would provide women with a more personalised approach based on individual risk.

The change follows a recommendation from the UK National Screening Committee and aligns with the current schedule for women aged 50-64 in England, as well as screening programmes in Scotland and Wales.

Evidence Supports Longer Interval

NHS England highlighted that studies have shown that people who test negative for HPV are extremely unlikely to develop cervical cancer within the next decade. 

Research led by King’s College London and published in The BMJ in 2022 found that 5-yearly screening for HPV-negative women was as safe as 3-yearly screening. The study reported no difference in the number of cancers detected and confirmed that less frequent testing was needed.

Women who test positive for HPV, with or without abnormal cell changes, will continue on shorter recall. Those with no cell changes will be invited for re-screening in 1 year, while HPV-positive women with cell changes will be referred for colposcopy.

Women will continue to follow the recall schedule advised at their last screening. Only those screened on or after 1 July and meeting the criteria will move to the 5-year interval.

Screening Based on Personal Risk

Cervical screening was first launched in the UK in 1964. Since 2019, all cervical screening samples collected in England have been tested for high-risk HPV, which is more accurate than the previous method of cytology testing.

Cervical cancer is the 14th most common cancer in the UK, with around 3300 new cases each year, nearly all of which are caused by HPV.

Since 2008, girls in school year 8 have been offered a vaccine against certain strains of HPV. The programme was extended to boys in 2019.

Evidence shows that the vaccine has reduced cervical cancer rates by 90% in England. In Scotland, there have been no recorded cases among vaccinated women since the schools programme was introduced for girls in 2008.

Michelle Mitchell, chief executive of Cancer Research UK, said, “Screening, alongside the roll-out of the HPV vaccine, has seen cervical cancer rates drop by around a quarter since the early 1990s.” 

Dr Sue Mann, NHS national clinical director for women’s health, said, “Taking a more personalised approach to cervical screening will help ensure everyone eligible can make the most of these life-saving services, while sparing women appointments that they don’t need.” 

Athena Lamnisos, chief executive of The Eve Appeal, said, “This new guidance is good news for those at low risk, because they will no longer need to go for cervical screening as often.”

Digital Reminders Aim to Boost Uptake

The NHS has introduced digital invitations and reminders for cervical screening through the NHS App, as part of a new “ping and book” service to boost uptake.

Eligible women will first receive a notification through the app to alert them to book a screening appointment. If not opened, a follow-up text message will be sent. Paper letters will still be used for those who need them.

The 2023-2024 NHS Cervical Screening Programme annual report for England found that 68.8% of women aged 25-64 were screened within the recommended timeframe, a slight increase from 68.7% the year before. Coverage was highest among women aged 50-64 (74.3%) and lowest among those aged 25-49 (66.1%). 

Louise Ansari, chief executive of Healthwatch England, welcomed the move to digital invites. 

“Nearly half of the women we polled last year said the ability to book screenings via the app would make them more likely to attend future appointments,” she said.

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.