Another screening success story: England changes cervical screening to every 5 years

Today, NHS England announced it will be updating its cervical screening programme so that eligible 25 to 49-year-olds are invited every five years instead of every three years if their routine screening (sometimes known as a smear test) shows they do not have HPV.

The change, which will come into effect from July, follows recommendations from the UK National Screening Committee, an independent body of experts who review screening evidence and advise the four UK governments. Scotland and Wales made the same change in 2020 and 2022 respectively.

But why is this change happening and what could it mean?

The change from screening every three years to every five years for those aged 25 to 49 comes following an improvement in the screening test.

Previously, the test only looked for abnormal cell changes in the cervix. The new and improved test was introduced in England in 2019, and first looks for high-risk strains of HPV (the human papillomavirus), which causes 99.7% of all cervical cancers.

If the new ‘HPV primary’ screening test finds high-risk HPV in cervical cells, the cells are then tested for abnormal changes. If this second test shows no sign of any abnormal cells, the person will be invited back for screening in one year. If abnormal cells are present, they will be offered treatment and also invited back for another screening test in one year.

As HPV infection happens before abnormal cell changes, testing in this way means people at a higher risk of cervical cancer can be identified earlier and invited for more regular screening. If someone does not have high-risk HPV and does not have a recent history of HPV, then they are at a very low risk of cervical cancer and can be safely invited back for screening in five years’ time.

Analysis of a pilot of this approach, which researchers at King’s College London ran with our funding, was published in the British Medical Journal in 2022. It showed that screening with HPV primary testing every five years is as safe as screening every three years and finds the same number of cancers.

What do I need to do?

Cervical screening is offered to women, some transgender men and some non-binary people aged 25 to 64 in the UK.

Those aged 50 to 64 are already invited for screening every five years as standard. The NHS has explained that the shift for 25 to 49-year-olds will not change any current due dates. People will still be invited after the interval they were given at their last test. Then, from 1 July 2025, those whose screening tests show no signs of HPV will have their next test due date set at five years, rather than three.

To be invited for cervical screening you must be registered with a GP and ensure they have your up-to-date contact details. Then, look out for your screening invite; you can now get this through the NHS app, so be sure to turn on notifications.

You can find out more about cervical screening here. We also have an article with tips on making cervical screening more comfortable for you. If you’re trans or non-binary, you can find out how to take part in cervical screening here.

It’s important to remember that cancer screening is for people without symptoms. If you notice anything that is not normal for you, don’t wait for your screening invite, contact your GP.