HPV test could reduce the risk of cervical cancer in over-65s, study finds
- Women 65 and over could benefit from HPV tests, new Danish study suggests
- But the NHS does not usually offer screening to women of this age
Women over the age of 65 could benefit from an HPV test to reduce their risk of cervical cancer, a study suggests.
In England, the NHS cervical screening programme does not routinely offer screening to women aged 65 and older.
But some experts argue there should be a ‘catch-up’ programme inviting older women to be tested for high-risk forms of human papillomavirus (HPV) – which increase women’s risk of developing cervical cancer.
A new study carried out in Denmark compared more than 11,000 women offered such a catch-up HPV test to almost 33,400 women who were not invited for the test.
Among the women invited for the HPV test, who were examined more closely if they had high-risk HPV, almost four women in every 1,000 were found to have pre-cancerous cervical lesions which, untreated, could go on to become cervical cancer.
In England, the NHS cervical screening programme does not routinely offer screening to women aged 65 and older (file photo of HPV screening kit)
The rate of these lesions was far higher than in older women not invited for an HPV test, among whom only 0.3 women in every 1,000 on average were found to have lesions.
The women would need to be followed up for longer to see if those invited for an HPV test ended up with a lower rate of cervical cancer as a result (SUBS – pls keep).
But Dr Mette Tranberg, who led the study from Randers Regional Hospital in Denmark, said: ‘A catch-up HPV screening test could potentially improve cervical cancer prevention in women aged 65 years and older who have never had an HPV test.’
Many older women in the UK may have missed out on a HPV test.
Standard smear tests, which look only for abnormal cells in the cervix, were the only form of screening available until HPV tests, which identify those at higher risk of cervical cancer earlier, were introduced in England in 2019.
In England, women aged 65 and older can request a screening test if they have never had an HPV test, but will not be invited for one.
They will also continue to be tested past this age if they were positive for the high-risk strains of HPV at their last screening, or had abnormal results.
But the new study looked at women aged 65 to 69 who were specifically invited for an HPV test, which does not routinely happen in this country.
These women had not been screened in the previous five and a half years or more, and had received no HPV test after the age of 60.
The results, published in the journal PLOS Medicine, show a more than 10 times higher rate of cervical lesions picked up in this group compared to women of the same age receiving standard cervical care in Denmark.
Standard care meant they could request an HPV test, but this would likely be if they had a cause for concern, such as post-menopausal bleeding.
The Danish researchers suggest women who have missed out on screening in middle-age, having one or zero smear tests between the age of 50 and 64, would benefit most from catch-up HPV tests.
The study also identifies a way to try to get more older women, who may be worried about embarrassment or pain, to opt for an HPV test, which is done using cells removed from the cervix during a standard smear test.
Researchers offered women the choice of seeing a doctor for the test, or collecting a vaginal screening sample themselves in their own home.
They found the self-testing kit was almost twice as popular among women who had one or zero smear tests between the age of 50 and 64, compared to those who had more screening.
In England, women aged 65 and older can request a screening test if they have never had an HPV test, but will not be invited for one (stock photo)
Finding new ways to encourage women to get cervical screening, when they have been reluctant in the past, is particularly important in the UK.
A previous study found women not screened since the age of 50 were almost six times more likely to develop cervical cancer over the age of 65.
Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust, said (SUBS – pls keep): ‘Taking up your invitation for cervical screening at any age can help stop cancer before it starts.
‘If you’ve never been, or haven’t been since you turned 50, you can still book a screening when you are over 65.
‘Speak to your GP if you experience any cervical cancer symptoms.’
A spokesman for the Department of Health and Social Care said: ‘The UK National Screening Committee makes evidence-based decisions and we know for those aged 25 to 64 the benefits of cervical cancer screening outweigh the harm it can cause.
‘If you’re 65 or older and have never had a cervical screening, or have not had cervical screening since the age of 50, you can ask your GP for a test.
‘To address the challenges of people attending their screening appointments two studies have been established to investigate self-sample testing.
‘This allows people to take a sample in the comfort of their own home, helping to reduce concerns about the procedure and enabling people who cannot travel easily to be screened.
‘Findings will inform any UK National Screening Committee recommendations.’
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