Just 12% of women know how HPV testing is used in cervical screening

A new study funded by Cancer Research UK has revealed a gap in many women’s understanding of HPV (human papillomavirus) and its role in cervical screening (previously known as smear tests). 

In the UK, people are encouraged to attend their cervical screening appointment, which aims to prevent cervical cancer. But a survey conducted by researchers at King’s College London showed that just 12% of women understood the role of HPV testing within the screening process. It also found only 14% of participants mentioned HPV as a cancer risk factor.

What is HPV?

You may have heard of HPV before. It’s a virus that can cause cervical cancer in its high-risk form, as well as some other cancer types.

Even though HPV infection itself is common, it’s very rare for it to lead to cancer.  Most people will have an HPV infection at some point in their life, but only a small percentage of people will develop a cancer linked to HPV. 

Cervical screening is for people without symptoms, and aims to prevent cervical cancer from developing. It is offered to most women, some trans men and non-binary people with a cervix, aged 25 to 64. HPV primary testing was introduced into England’s cervical screening programme in 2019, aiming to pick up high-risk strains of HPV with the potential to cause cancer.

That hasn’t resulted in a difference to the screening appointment itself – it just means that, when the cell sample gets to the lab, it’s first analysed for HPV. Then, if HPV is found, the sample will be further analysed to check for any cell changes that could lead to cancer if left untreated.  

Mind the gap

Attending cervical screening is a personal choice, but the survey found a correlation between cervical screening attendance and an understanding of HPV. The researchers believe this could show the impact of sharing health information during appointments and that more work is needed to reach people who aren’t currently able to make an informed choice. 

The latest figures from NHS England (2021-2022) for cervical screening show that almost a third (30%) of eligible people did not attend their cervical screening appointment when they were last invited.

“While positive strides have been made to increase awareness of HPV, our research reveals major gaps in women’s understanding of current approaches to cervical screening,” says Professor Jo Waller, lead of the study and now Professor of Cancer Behavioural Science at Queen Mary University of London. 

“Improving awareness can help to reduce feelings of uncertainty and confusion about screening results. It will also help people understand the reasoning behind any future updates to the screening programme, such as HPV self-sampling and changes to intervals between screening appointments.”  

Screening saves lives 

Cancer Research UK has been at the heart of decades of pioneering research into understanding and preventing cervical cancer. The charity’s scientists proved the link between HPV and cervical cancer more than 20 years ago. 

Thanks to these scientific developments, including the HPV vaccine and screening, cervical cancer rates have fallen by over a quarter since the early 1990s. But it’s still important to remember that there are around 3,300 people who receive cervical cancer diagnosis every year in the UK (2017-2019). 

“The cervical screening programme is estimated to save at least 2,000 lives from cervical cancer every year in the UK and this number is likely to increase thanks to HPV testing,” says Dr Julie Sharp, Cancer Research UK’s head of health and patient information. “Everyone should have equal access to screening, but barriers to participation can often lead to inequalities in diagnosis and treatment. If we’re to eliminate these inequalities, we need more research like this.”  

“It’s vital that the UK Government continues to work with individuals, communities and services to ensure that accurate information about HPV reaches those who need it.”

Gem’s story