Could At Home Cervical Cancer Tests Help Increase Screening Rates?

Cervical cancer is one of the more common cancers affecting women (or anyone with a cervix, really) and is screened from the age of 25. I’ve now had two, I’m due my next one around March 2020. I recently read a news article about at home self sampling cervical cancer screening tests possibly increasing and becoming ‘the norm’ within the next five or so years. You can read the full article here. I can’t comment on the science but I can comment on how I feel about cervical screening.

Cervical cancer is incredibly serious, and, according to healthcare professionals, in many cases be prevented or dealt with early enough should you attend your regular cervical screenings. I had a conversation with my nurse about it last time who said the reason it’s every three years is because that’s usually the time it may or may not take for cell changes to become present on the cervix. I’ve had a baby since I last had a screening so my cervix has been through quite a bit! If any cell changes are detected, further tests are offered. I have had both tests come back clear but there’s always the chance they won’t and further screening is offered. I’ve read stories from friends who have also had further screening and whilst it doesn’t sound pleasent, I’d argue that it’s better than cancer.

Why Don’t We Attend Cervical Screenings?

I’d say the most common reason is embarressment. By the time I’d had my first cervical screening I’d already had a baby. Enough midwives and doctors had already seen everything down there but that didn’t really help because I didn’t know what to expect. Does talking about our experiences help encourage others to go? It might do, but it might not. I mean, it’s not something that comes up in conversation is it. Even though it’s a regular screening that’s really important, any kind of health care check to do with genitals, or unseen bits, makes us feel uncomfortable. There’s a huge element of self-conciousness about health care checks that involve our bits.

I can tell you that the two screenings I’ve had have been minutes long. I’ve had privacy to get undressed and dressed again. It hasn’t really been painful but I’ve had a few cramps afterwards and felt a little delicate. I’d say thats probably more mental than physical though. It’s something that you don’t really want to do and well the vagina doesn’t really like it when you’re not completely relaxed. My advice is to take a few long, deep breaths before, counting for 4 as you inhale and then 8 as you exhale. Another tip I’ve learned is relaxed shoulders means a relaxed pelvis so trying to keep your shoulders down rather than up at your ears might make it a little bit easier.

The fact is cervical screening is not easy for everyone and I can completely sympathise with that. I don’t doubt that victims of rape and sexual assualt find this to be incredibly difficult to experience. I understand that for some people the screening is really painful. I know first hand what it’s like to be fat shamed during a cervical screening and yes, it has made me doubt having another one because my weight has nothing to do with my screening and everything to do with the fatphobic attitude of the healthcare professional doing the screening. Perhaps cervical screening is incredibly uncomfortable and difficult for intersex, transgender or individuals at war with gender dysphoria. There are so many social constructs that make cervical screening hard and why so many people put it off.

How Could At Home Tests Help?

I think it could make a huge difference actually. I think this would see cervical cancer screening rates rise hugely. If women were taught more about there bodies and actually encouraged to look at themselves down there to check things where okay perhaps the embarressment might fade a bit. It seems that the test is a urine sample and a vaginal swab and I am sure many, many people would prefer to do this at home. It looks like the inital use of self sampling would be for those that don’t attend after being invited to their screening or in countries where routine screening is not offered. In the long term, it could be that at home self sampling is the way forward.

So far more than 600 women have taken part in a study for this who had either abnormal smear results or tested positive for HPV (the virus known to cause the cells to change cancerous). Of course there is the vaccination offered too but with the anti-vax community growing there is probably less uptake of this too. Women were asked to self sample with a vaginal swab and it correctly identified high risk pre-cancerous cells in 96% of samples. This is encouraging to know that it has been successful because it sounds much less invasive than the cervical screening at the moment.

Dr Nedjai added: “We are currently working on new markers to try to improve the accuracy of the classifier even further, but these findings represent an advance in cervical cancer screening, especially for women who do not attend the clinic, such as older women, or women who find the smear test too painful or who do not have access to a screening programme in their country. We think it’s promising.”

https://news.sky.com/story/home-urine-testing-kit-could-make-cervical-cancer-smear-test-obsolete-11854461

Would I use self sampling in the future?

Absolutely. I don’t like going to the doctors and being fat shamed. I would self sample and if I needed further tests then of course I would go. I would prefer the results to be a little more accurate but then even the initial screening isn’t going to be 100% accurate. Sometimes the cervix is too high, the patient needs to stop for whatever reason or the cells simply aren’t good enough. Self sampling could be the cost effective and time saving breakthough that would encourage more screenings and is a change I would welcome.