Summary

1. HPV is the virus that causes cervical cancer

2. Vaccination against HPV will almost certainly reduce the risk of cervical cancer in the future

3. Unvaccinated women can be tested for the presence of HPV

4. Investigating women with positive HPV tests can detect pre-cancer in the cervix

5. Treating pre-cancer (CIN) of the cervix can prevent cervical cancer

6. HPV tests detect more cervical disease than cervical smears

7. HPV infection is common and normally resolves on its own

8. HPV tests are often positive when there is no significant disease to treat (especially in women under 30 years of age)

9. HPV tests when negative almost certainly rule out any serious disease of the cervix (a negative test is highly reassuring)

10. Self-testing for HPV is nearly as accurate as HPV testing from a cervical smear and just as accurate as current smear tests

Frequently asked questions -

1. What is self-testing?

By using a swab a woman can take a sample from her own cervix in the privacy of her own home that can be sent for HPV testing. Scientific studies have shown that self-tests are less accurate than samples taken by a doctor or nurse but the difference is not very great.

2. Should self-testing be used instead of routine cervical screening by smears?

No. Self-testing is best used in 2 scenarios; to supplement routine screening by smears, or in areas of the world where a smear programme is not established.

3. How accurate are the different types of cervical screening?

A routine NHS cervical smear can detect about 8 out of 10 abnormalities on the cervix. An HPV test taken from a smear can detect more than 9 out of 10 abnormalities on the cervix. A self-test can detect about 8 out of 10 abnormalities on the cervix (roughly equivalent to the current NHS smear test).

Frequently asked questions - 2

4. At what age should cervical screening start?

Currently women under 25 are not tested in England but in Scotland and Wales women are invited for cervical screening from the age of 20. Screening young women is costly because HPV infection and smear abnormalities are common and pre-cancer (CIN) in young women may resolve on its own. People argue that damage to the cervix from treating cervical abnormalities in young women can increase the risk of a baby being born prematurely. However, significant cervical disease can occur in young women and some women would put their risk of cancer ahead of the risk of a premature birth.

5. At what age should cervical screening stop?

Women over 64 do not receive routine invitations for NHS cervical screening. However, there is a small peak in the incidence of cancer of the cervix in older women and arguably this is due to a lack of screening in this age group. Smears are more difficult to interpret in older women because age-related changes can mimic the changes of pre-cancer (unless taking HRT). However, HPV tests ought to be just as effective in older women as in younger women.

6. What are the disadvantages of HPV testing?

Disease that is not harmful is commonly detected and this may need to be monitored until it resolves. Some partners may find it difficult to understand how an HPV infection of the cervix can arise and confidentiality may be an important consideration.

7. Can women over 20 years of age be vaccinated?

Yes. But vaccination will not be available on the NHS at this age because a high percentage of women will have been exposed to HPV by their early 20s and vaccination may be less effective.

Instructions for the Self HPV Test

There are 2 swabs in your pack.The first one you use is to clear any mucus from around the neck of the womb, the cervix. The second swab is the swab that will collect your sample. You are aiming to sweep the swab around the cervix as shown in the diagrams.

1. Take out the product without touching the swab head
2. Now take an easy position, approach the vagina and spread the labia
3. Gently insert the 1st swab into the vagina as far as possible and gently sweep around to remove mucus. Repeat with the 2nd swab (inserting at least 5 cm) to ensure optimum sampling. You should aim to place the swab at the neck of the womb
4. When placed correctly make 3 full rotations with the swab and then remove it from the vagina. Put the swab in the collection tube, snap off the stick and secure the lid.

How do you order an HPV self-test?

Online at www.oxfordscreening.co.uk/portfolio.html#hpv using a credit card or PayPal account.

Cost £80.00 + post and packing

By phone witha credit card – 01865-763140

By cheque payable to ‘Oxford Screening LLP’ sent to Oxford Screening, 33 Kennett Road, Headington, Oxford OX3 7BH