New smear test that women only need once every 10 years

WOMEN should only have to visit their doctor every decade for smear tests, a study has suggested.

At present women are asked for a smear test every three years if they are 25 to 49, and every five years between the ages of 50 and 64.

But a new cervical screening test is so sensitive that women over 40 may only need it once a decade.

In an NHS-funded study, which will be considered by the National Screening Committee, researchers followed almost 25,000 women for more than a decade.

They found the danger of cervical cancer and ‘pre-cancer’ was extremely low in those given a new HPV test which detects a risk of cervical cancer earlier than conventional smear tests. Only one in 100 women in their twenties who tested negative for HPV reached the pre-cancer stage over the next decade.

Women over 40 are far less likely to get HPV – the virus which can lead to cervical cancer and is picked up during sex.

Only around one in 1,000 women of this age went on to get pre-cancer, leading the authors to conclude that ten years between tests could be reasonable for this age group. They say it could perhaps also be considered for younger women.

Professor Julian Peto, the cancer researcher from the London School of Hygiene & Tropical Medicine who led the report, said: ‘These results show the risk of pre-cancer or cancer is ten times less in women over the age of 40 than those in their twenties, so a ten-year wait between appointments may be appropriate for older women.

‘The downside is the risk that if women do not get an invitation for screening for ten years, they may get out of the habit of going.’

Currently women are invited for cervical cancer screening 12 times in their life, which many find uncomfortable and embarrassing.

Cervical screening uptake is at an all-time low in Britain, with five million women now overdue for testing.

Some experts believe repeated ‘all-clear’ results can put them off going back and that less frequent appointments might be less inconvenient for women as well as less costly for the NHS. The HPV test could clear the way for this when it is rolled out across Britain by the end of the year.

Instead of detecting abnormal cells in the cervix, like the traditional smear test, it picks up the HPV virus which can cause those abnormalities.

That means it can pick up cancer risk at an earlier stage. The British study of the test followed 24,510 women, of whom 482 got pre-cancer and 23 were diagnosed with cervical cancer after screening.

Among women who tested negative for the HPV virus, just 1.1 per cent of those aged 20 to 24 went on to get cancer or pre-cancer. Women over 40 were only a tenth as likely to get cancer or pre-cancer, with a rate of 0.11 per cent.

Almost three-quarters of women who did test positive for HPV had naturally got rid of the virus three years later, giving it less time to mutate their cells and switch off important cancer-fighting genes.

This meant fewer than one in 60 women in this group ended up getting cancer or pre-cancer.

The risk is higher in women who hold on to the same type of HPV over three years or more, and around one in five of these are at risk of pre-cancer, which means they need frequent smear tests until the HPV disappears or they are treated.

But although this group might need more regular smear tests, other women would not.

The authors conclude: ‘A screening interval of up to ten years following a negative HPV test might be considered for women aged 40 years or older and perhaps for younger women following a negative HPV test.’

Robert Music, chief executive of Jo’s Cervical Cancer Trust, said: ‘This is good news for women attending screening.

‘However, more research and greater understanding is required before intervals longer than five years are considered.’

‘May get out of the habit of going’