HPV (Human Papillomavirus) and Cervical Cancer
There are over 100 types of the HPV virus which most adults will have at some point in their lives and the infection usually clears itself up without causing any problems. Although only some types of HPV can affect the cervix, 99.8 percent of all cervical cancers are caused by the HPV.
What is HPV Primary Screening?
People between the ages of 25 and 64 are invited for regular cervical screening under the NHS Cervical Screening Programme. These programmes differ across the UK. Currently Wales, England and Scotland use a test for HPV as its primary cervical screening test (it is also referred to as HPV primary screening). Northern Ireland does not use HPV primary screening yet, but it is hoped that this will be changed soon.
The ultimate aim of the screening programmes is to detect the presence of the HPV virus.
Previously, the primary test used was a cytology test, which aimed to detect cell abnormalities only. As HPV is the cause of almost all cervical cancers, it was decided that testing for the virus is more effective than looking at cells alone as this test allows changes to be found and treated earlier.
If HPV is found in the cervical screening sample, cytology will be undertaken and the patient will be recalled for a follow up every year, even if there are no cell changes.
Changes to Cervical Screening Wales Programme
Further to the introduction of the HPV primary screening, as of 1 January 2022, Wales extended the interval between routine cervical screening for people aged 25 to 49, from three to five years if HPV is not found in their cervical screening test. Scotland and Wales were the first to implement the new intervals in the UK.
In her statement dated 5 January 2022, Eluned Morgan MS, Minister for Health and Social Services in Wales said: “I would like to reiterate that the change has been made because the current screening is more accurate than previous testing and, therefore, less frequent screening is required for those who do not have HPV.”
Public Health Wales confirmed that it is safe to wait for five years. They refer that evidence shows if no high-risk HPV is found in a woman’s sample, the woman has a very low risk of developing cervical cancer within five years, as it takes around 10 to 15 years to develop after infection with HPV.
A study published in the Lancet shows that the HPV vaccine, which has been administered since 2008, has reduced the incidence of cervical cancer by 87 percent in women in their 20s in England. These women were offered the vaccine when they were aged 12-to 3 years as part of the UK HPV vaccination programme. Since 2019, the vaccine has been offered to boys too.
It is therefore hoped that in combination with the Cervical Screening, the HPV vaccination programmes will help eradicate cervical cancer in the UK within the next few generations.
In summary, if HPV is not found in the screening sample, depending on their residence area, the patient will be recalled as follows:
• For England and Northern Ireland – invitations are sent every three years for those aged 25 to 49. After that, it reduces to every five years until the age of 64.
• For Wales and Scotland – invitations are sent every five years for those aged 25 to 64.
Public Health Wales have produced a guide to help to answer any questions regarding the new changes to the screening programme. . Although the new change in the screening interval is promoted as a positive step, it has been widely criticised in the media. This may be as a result of poor and inaccurate messaging.
Public Health Wales has responded to criticism by explaining that the primary HPV testing is more sensitive and effective, explaining that it identifies those at higher risk, before cell changes have occurred, who need early follow up or referral for further investigation. They explain that the primary screening also aims to eliminate those at very low risk and to reduce the risk of potential harm associated with unnecessary treatment for those who may not need it. For example, repeated treatments for cervical abnormalities can weaken the cervix and increase the chance of premature births in pregnancy, this also being one of the reasons why the screening is not offered to women under the age of 25.
Cervical Screening is not a test for cancer
It is important to remember that cervical screening is not a test for cancer and is not appropriate for those presenting with symptoms of cervical cancer. It is advisable to contact the GP as soon as possible rather than waiting until the next screening is due. The GP can consider the need to refer for further rapid investigations.
The NHS website explains the main symptoms of cervical cancer and how to look out for any unusual changes.
Although the HPV vaccination protects against the most common types of high-risk HPV that cause cervical cancers, it does not protect against all types. This means that even those who had the HPV vaccine still need to go for cervical screening from age of 25.
How can we help?
If you have been diagnosed with cervical cancer and have concerns that diagnosis was missed, or if you suspect there was a delay in treatment that caused injury to health, we can assist you in pursuing a claim.
Guide published by Public Health Wales Changes to the Cervical Screening Wales programme - Public Health Wales (nhs.wales)
Written Statement: Change to cervical screening interval (5 January 2022) | GOV.WALES
Cervical screening in Wales extended to every 5 years: Why the switch? - Cancer Research UK - Cancer news
Cervical screening - NHS (www.nhs.uk)
HPV primary screening report published - PHE Screening (blog.gov.uk)
Cervical screening: programme overview - GOV.UK (www.gov.uk)
Cervical Cancer - UK National Screening Committee (UK NSC) - GOV.UK (view-health-screening-recommendations.service.gov.uk)
HPV & Cervical cancer: New screenings will save lives - top doctor - BBC News
The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study - The Lancet
HPV vaccine overview - NHS (www.nhs.uk)
Screening | Cervical cancer | Cancer Research UK
About cervical screening | Cervical cancer | Cancer Research UK
The HPV vaccine and cervical screening: how many tests do you need? - Cancer Research UK - Cancer news
Cervical screening - Macmillan Cancer Support
Symptoms of cervical cancer - NHS (www.nhs.uk)
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2023