Traditional cervical cancer screening is based on cytology and cell sampling, which initially reduced the number of cases substantially but additional effects have been difficult to achieve, which may be due to the limited sensitivity of the method and fact that not all women attend screening.
In this study researchers compared screening based on cytology and sampling conducted by midwives, with the patient taking self samples to submit for analysis of human papillomavirus, cervical cancer, and HPV. 36,390 women between the ages of 30 – 49 years old were involved in this study who had participated in the organised screening. Participants were divided into 2 groups with 1 performing self sampling for an HPV test, and the other group having a midwife collect cell samples for cytological analysis. HPV positive women after 4 months repeated the self sampling, with gynaecological examinations being arranged for participants that were HPV positive in both tests. During the 18 month period of follow ups for both groups the number of women with severe cell changes were documented.
Results show that self sampling was received positively with 47% of the women offered opting to participate. More than twice as many cell changes were found among those who had cytology analysis who did HPV self sampling, and the time until diagnosis was shorter for those who did self sampling.
This study is the first randomized study to compare these 2 methods of identifying cervical cancer. By using self sampling followed by HPV testing more than twice as many women could be identified that are at risk for cervical cancer and be offered preventive treatment. Women may be reached who have not participated in screening previously and have samples taken by a midwife and using self screening. Health-economic calculations of self sampling and HPV testing shows that the cost of cervical cancer screening could be halved, while being twice as effective.
