5MinuteConsult Journal Club
Non-Speculum Cervical Cancer Screening Improves Screening Rates
Br J Gen Pract; 2021 Dec 31;72(714):e26-e33.; doi: 10.3399/BJGP.2021.0350. Print 2022 Jan.
Lancet Reg Health Eur 2021 Nov 9;11:100235.; doi: 10.1016/j.lanepe.2021.100235.
This study randomized women aged 50-64 at 10 General Practices in the UK offering cervical cancer screening by non-speculum clinician sampling or self-sampling and compared them to a control group who received usual care.
At 4 months, screening was 20.4% in the intervention arm and 4.9% in the control arm. At 12 months, 30.5% were screened in the intervention arm and 13.6% in the usual care group. Ethnicity data implied White women preferred self-sampling more than those from Asian or Black patients, who preferred traditional speculum testing.
Cervical cancer remains a great health concern around the world, particularly in older populations who did not have access to the HPV vaccines. Apprehension to speculum exam is the most common reason to not be screened. Self-swabbing continues to be studied as a method to improve screening compliance and lower the morbidity and mortality from cervical cancer. This study shows the barrier to testing can be overcome by offering self-swabbing or clinician swabbing without a speculum, as an alternative to a speculum exam.
There is continued data showing self-collected high risk HPV testing is as, if not more effective at finding disease, and in particular cancer than clinical testing (Lancet Reg Health Eur 2021 Nov 9;11:100235. doi: 10.1016/j.lanepe.2021.100235.) The future of cervical cancer screening will likely rely upon self-testing. This increases patient autonomy and decreases discomfort, with the hope of lowering the morbidity and mortality from cervical cancer. A win-win!
More from 5MinuteConsult
Contributed by Frank J. Domino, January 26, 2022