Offer self-sampling HPV kits in practice appointments to increase uptake

Offering HPV self-sampling kits opportunistically during routine appointments is an effective way to increase cervical cancer screening uptake among women who are overdue for a test, researchers suggest.

A new study reports that when self-sampling kits were offered in person by a healthcare professional during an unrelated general practice appointment, more than half returned the sample.

The NHS will soon offer home testing kits to women in England who have missed recent smear tests. The new approach could potentially prevent up to 1,000 cases of cervical cancer annually.

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The findings, published in eClinicalMedicine, show that many women welcome the option to sample at home and avoid an internal examination.

Almost a third of women overdue for screening

Cervical screening can prevent cervical cancer, but the researchers, led by academics at Queen Mary University and King’s College London (KCL), say that almost a third of women in the UK are overdue for an appointment. Delays in seeking a test can be due to discomfort, embarrassment, or a lack of time.

Previous research in the YouScreen trial, undertaken by the same research group, shows that women welcomed the idea of using a self-sampling kit, rather than visiting their GP for a cervical smear test. The researchers aimed to build on this work and determine the most effective way to present this option to women, ensuring the highest uptake and return of sample kits. To do this, they recruited women who were overdue for their cervical screening. They compared sending a letter offering a kit, mailing a kit, or handing a kit to eligible patients if they came to see their GP or a nurse for another reason.

The researchers recruited 13 GP surgeries to the study, and divided the practices into two groups, with approximately 6,000 women who were six months or more overdue on their smear test. They offered one group an HPV self-testing kit when they visited the GP. This service was not offered to the second group.

In addition, for women who were 15 months overdue for a screening, the researchers sent a self-sampling kit directly to a quarter of these women. Another quarter received a letter offering a kit, while the other half received no additional communication.

Offering the kit in person was most effective

Offering a self-sample kit in person was found to be the most effective method of encouraging completion of cervical cancer screening tests. Of the 449 women opportunistically offered a kit during a GP appointment, 52 per cent accepted and returned a sample.

Related Article: Government to introduce HPV self-sampling for ‘under-screened’ women

The uptake of self-sampling after a postal offer was lower, with 12 per cent of those sent a kit returning the sample, and just 5 per cent of the women sent a letter with the offer of a kit.

Despite the low numbers of women contacted via post, the researchers point out that more women were screened than would otherwise have been, given the busy nature of both practices and patients, suggesting that a combination of approaches may be best for enabling more women to participate in cervical screening.

Dr Anita Lim, from KCL and Chief Investigator of the trial, said: ‘These findings are directly relevant to current efforts to modernise cervical screening in England. Self-sampling gives women greater control over how and when they get screened. A simple change like this could have a major impact on preventing cervical cancer.’

Fiona Osgun, head of health information at Cancer Research UK, added: ‘We welcomed the government’s decision last month to roll out cervical home screening kits in England for people who don’t take up their invite. This study shows that offering these kits during GP appointments could be part of an effective approach to making screening more accessible and remove barriers. Beating cervical cancer means beating it for everyone, and research like this is vital to help bring us closer to that goal.’

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Reference: Impact of mode of offer of self-sampling to people overdue cervical screening on screening participation: a randomised controlled trial DOI: 10.1016/j.eclinm.2025.103357