Since 2008, the HPV vaccine has been offered to girls aged 11 to 13 and reported cases of HPV have fallen sharply since then. A team from Queen Mary University of London has found that smear tests at age 30, 40 and 55 would offer the same benefit to these young women as the current 12 smear test programme.
At the moment, laboratories check for abnormal cells taken in a smear test but the new tests will look for the presence of HPV first and only check for abnormal cells if the virus is found. Those young girls with the virus can then receive the HPV vaccination. The study says that when the new HPV testing first comes in, even unvaccinated women should only need seven screenings in their lifetime, instead of 12.
Testing for HPV first will be rolled out into the English cervical screening programme over the next two years. A new HPV vaccine is also expected to be introduced at some point from 2019. It reportedly should have a 90% success rate, a significant increase from the 70% success rate for the current vaccine. With this new vaccine, the researchers believe vaccinated young women will only need a further two smear tests in their lifetime.
While it is positive to see a potential reduction in the screenings needed, focus must continue on increasing the uptake of the vaccination and screening programmes to ensure more women are able to benefit from these advances. There is a fear that screening attendance rates may fall and more lives be lost to the disease which could have been prevented.
Cervical cancer is one of the most deadly but most preventable forms of cancer in women and it is the most common cancer in women under 35. Around 3,000 cases are diagnosed every year in the UK and it causes 900 deaths. Currently 85% of eligible girls are immunised and HPV vaccine rates in England are among the world's highest. The vaccine could save several hundred lives every year and also provide protection against other cancers and genital warts.
Penningtons Manches LLP’s clinical negligence teams works with women who may have suffered a delayed diagnosis of cervical cancer due to errors in their medical care. This may, for example, be an error on the part of a laboratory in assessing smear test results and identifying abnormal cells.
In a recent case, a lady underwent routine smear tests three years apart and on both occasions, her results were reported by the laboratory as normal. However, she developed bleeding and pain and was worried about her health. She saw her GP, who referred her for further tests and a diagnosis of cervical cancer was then made. She underwent a radical hysterectomy and removal of lymph nodes. Whilst that surgery was successful in terms of treating her cervical cancer, she was left with bladder damage and was no longer able to have children, as she had wanted to do. This caused her a psychological injury on top of her physical injuries. Upon investigation, it was established that the original two smear tests had been reported upon incorrectly, constituting negligence, and the delay in diagnosing cervical cancer had huge significance. With a timely diagnosis, this lady would not have required a hysterectomy or lymph node removal and would have preserved her fertility. Her case settled and she received considerable compensation.
Alison Johnson, associate director at Penningtons Manches, who represents women with claims arising from negligent gynaecological care, comments: “The advances in HPV testing and vaccination will of course save many women the need to undergo as many smear tests, which can be an uncomfortable procedure, and will free up resources, saving the NHS valuable funds. However, it is essential that this change in the screening programme does not detract from the importance of smear testing and catching cases of cervical cancer as early as possible. We see the tragic circumstances of late diagnoses when treatment is no longer likely to be successful.”