Welsh government and Public Health Wales respond to criticism over extension in cervical screening interval

The Welsh Government and Public Health have responded to criticism over the extending the interval for cervical screening from three years to five.

It comes after a backlash from members of the public, who say the changes could put thousands of lives at risk by missing early cell changes.

In Wales smear tests, have been offered to women and people with a cervix aged between 25 and 49 every three years.

However as of January 1 Cervical Screening Wales (CSW) extended the routine screening for the age group from three to five years – if human papillomavirus is not found in their cervical screening test.

Public Health Wales say the change “is as a result of the current screening being more accurate than the previous screening test” and brings the advice for this age group in line with the screening interval for those aged 50 to 64.

Cervical screening is not a test for cancer; it is a test for the virus that causes it.

Human papillomavirus (HPV) is a very common virus that most people will have at some time during their life but only certain types of HPV cause cervical cancer.

Since September 2018, CSW has routinely used a cervical screening test which looks for the 14 high-risk types of HPV that cause 99.8 per cent of cervical cancers.

Where HPV is detected, it can be many years before cells start to change into something sinister.

But the change from three to five years has been heavily criticised by members of the public, who fear lives will be put at risk.

There are around 160 cases of cervical cancer diagnosed every year in Wales and it is the most common cancer in women under the age of 35.

A petition launched earlier this week by Rachel Paul has already received 645,634 signatures and has received the backing of the Welsh Conservatives.

Welsh Conservative and Shadow Health Minister Russell George MS said: “While I am pleased to see HPV checks become more reliable and effective, I find it difficult to see why this change is necessary.

“Hopefully, the Labour Government is not using this as a chance for penny pinching, because more effective tests will only be more effective if conducted more regularly.

“Once every three years is hardly a burden on women who want peace-of-mind and should not be one for NHS.

“The way this petition has taken off and the strength of feeling out there should surely force the Labour Government to at least re-consider the changes they propose to make regarding these life-saving checks.”

However Public Health Wales and the Welsh government have moved to reassure the public about the change, which has been recommended by the UK National Screening Committee in 2019.

Since 2008 girls aged 12 or 13 have been offered the HPV vaccine across the UK to help protect against cervical cancer.

Research has shown that the vaccine has led to about a 90 per cent reduction in the number of people with pre-cancerous cells.

Louise Dunk, Head of Programme for Cervical Screening Wales at Public Health Wales said: “Testing everyone who attends for cervical screening using a test for high risk HPV will identify those at risk and prevent more cancers than just examining the cells alone.

“It is a really positive development that this more effective test will mean that people with a cervix, who test negative for HPV, now only need to attend their testing every five years, rather than three.

“Going for your screening appointment could save your life. By making an appointment you have the chance to prevent cervical cancer from developing, or picking it up at an early stage when it is more treatable.”

Health Minister Eluned Morgan said: “I would like to reiterate that the change has been made because the current screening is more accurate than previous testing and, therefore, less frequent screening is required for those who do not have HPV.

“Those who are identified as having HPV will be followed up closely, either by being referred for further review at a hospital colposcopy clinic or by invitation for a further test in a year’s time if there were no cell changes present in their sample.

“The change to the screening interval has been made in line with the independent, expert advice of the UK National Screening Committee, which made the recommendation for the interval change in February 2019 after undertaking a public consultation.

“This is therefore the current evidence-based recommendation at a UK level. It was implemented in Scotland in March 2020.

“The change is now being made in Wales as the evidence has shown it is safe to extend the screening interval due to the improved test.”

Cervical screening is not appropriate for people displaying symptoms of cervical cancer as it is not a test for cancer. If anyone has possible symptoms of cervical cancer then they should speak to their GP who will consider the need to refer people for rapid investigation.