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Public Health Wales apology over lack of clarity on smear test changes

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PUBLIC HEALTH WALES has apologised and admitted it hasn’t “done enough” to explain the reasons for increasing the length of time between cervical screening tests.

The change, which was announced on Tuesday, means people aged between 25 and 50 with a cervix will now wait five years until another test, rather than three, providing no human papillomavirus (HPV) cells are detected.

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

HPV testing was successfully introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

There are about 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

But Public Health Wales has admitted it has failed to give clear information over the change, leading to concerns cancers could be missed.

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In a tweet this weekend PHW said: “We are sorry. We haven’t done enough to explain the changes to cervical screening and have caused concern. We are working to make this clearer and more information will be available as soon as we can today and in the coming days.”

Cancer charities have sought to reassure women concerned by the change. Cancer Research UK has said people should be aware increasing the gap between screenings is “safe” and the new form of testing means people are invited for further based on their risk of developing cancer rather than their age.

An online petition, calling for the reintroduction of the three year gap between routine smear tests, has now attracted more than 680,000 signatures.

Alice Davies, Cancer Research UK’s health information manager, said people should be aware the decision to increase the time between screenings was made on scientific advice and due to a new way of testing samples which detects human papilloma virus (HPV) and means doctors are better able to identify those at risk of developing cervical cancer.Ms Davies said: “As the new test is more accurate at finding those at risk of cervical cancer, screening intervals can be safely extended from three to five years.

“If someone is HPV positive then their next screening interval will be shorter than five years. The new test allows women to be invited back for screening based on their risk of developing cervical cancer, rather than just their age.

“Overall this makes the programme more accurate, and means people don’t have extra rounds of screening that wouldn’t give them any benefit, while offering more screening to people at higher risk.”On Wednesday Public Health Wales said it accepted it has to do more to explain the reasons for the change.

Charity Jo’s Cervical Cancer Trust, described as the UK’s leading cervical cancer charity, has sought to reassure people concerned about the changes.

It has said the change has been introduced following advice from the UK National Screening Committee which recommended the five year gap between tests due to the use of HPV tests which are more sensitive and effective.

It said this means the advice is most women aged 25 to 49 can, as those aged 50 to 64 are, can be tested every five years rather than three.

The charity says the improved testing will likely mean more lives saved by identifying those at greater risk of cancer earlier.

According to Jo’s Cervical Cancer Trust women in Wales, and Scotland, are invited back based on the result of the screening.

If those show high-risk HPV and cell changes you will be invited to colposcopy.

If it identified high-risk HPV but no cell changes you will be invited for cervical screening in one year.

If there is no HPV you will be invited for cervical screening in five years.

Public Health Wales says HPV testing was introduced in Wales in 2018 and almost nine out of 10 results show no high-risk HPV.

Heather Lewis, consultant in public health for Cervical Screening Wales said: “The HPV test we now use in Wales is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer.

“The evidence shows that it is therefore safe to extend the time between cervical screening tests for people who do not have HPV identified.”

HPV is a very common virus that most people will come into contact with at some time during their lives. One or more high-risk types of HPV are present in over 99.8% of cervical cancers.

Increasing the time between smear tests will also reduce risks from screening.

Head of Programme for Cervical Screening Wales at Public Health Wales, Louise Dunk said: “Testing everyone who attends for cervical screening using a test for high risk HPV will identify those at risk and prevent more cancers than just examining the cells alone.

“It is a really positive development that this more effective test will mean that women and people with a cervix, who test negative for HPV, now only need to attend their testing every five years, rather than three.”

There are around 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

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