Offering self-collection kits at routine GP appointments could prevent cervical cancer in 1,000 women a year
Women who are overdue for cervical cancer screening are most likely to participate in screening when self-sampling kits are offered by healthcare professionals as part of routine GP appointments, according to a new study led by Queen Mary University of London, with colleagues from King’s College London. Over half of people offered an at-home test during an unrelated GP appointment returned the sample. If this approach were adopted across the NHS, it is estimated that as many as 1,000* women would be prevented from developing cervical cancer every year.
Home-testing kits for HPV will soon be offered to people in England who are overdue for cervical cancer screening, giving women and people with a cervix the option to stay up to date with cervical screening without having to have an internal examination.
Senior researcher, Professor Peter Sasieni CBE from Queen Mary University of London explained: “We already knew that many women preferred using a self-sampling kit, rather than visiting their GP for a cervical smear test. But we didn’t know whether the way this option was presented would make a difference to how many samples were returned for testing. We studied women who were overdue their cervical screening. We compared sending a letter offering a kit, a kit in the post, or handing a kit to eligible patients if they came to see their GP or a nurse for another reason.”
The study recruited 13 GP practices in west London, randomly divided into two groups, each with approximately 6000 women who were overdue screening. One group of GP practices made in-person kit offers to women who were at least 6 months overdue for their cervical screening, and the other group did not. When women in the first group attended their GP practice for any reason, their doctor or nurse was encouraged to offer them a self-sampling kit. Each month, people who were 15 months overdue for cervical screening were randomised, so that half received no special communication, a quarter were mailed a self-sampling kit, and a quarter were sent a letter offering a kit.
“Our study showed that offering a self-sample kit in person was the most effective method of encouraging women to complete their cervical cancer screening tests. Of 449 women opportunistically offered a kit in a GP appointment, 234 (52%) accepted and returned a sample,” confirmed Professor Sasieni. “The uptake of self-sampling after a postal offer was lower: 12% among those sent a kit, and just 5% for women sent a letter offering a kit. But as letters and kits were sent regardless of whether women consulted with their GP, and regardless of how busy their GP practice was, in total more women were screened thanks to the systematic offer at 15 months than the opportunistic offer in the GP practice. This shows that a combination of approaches may be best for enabling more women to participate in cervical screening.”
“Cervical cancer is the most preventable of cancers. Women born before 1990 will not benefit from HPV vaccination, but they can reduce their risk by 80-90% if they are screened regularly.”
Dr Anita Lim, Lead Epidemiologist on the study and Chief Investigator of the YouScreen trial from King’s College London, 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 are screened. In the YouScreen trial, we saw how effective self-sampling can be in reaching women overdue for screening. This study reinforces that many women welcome the option - particularly when it’s offered in person by a trusted healthcare professional. A simple change like this could have a major impact on preventing cervical cancer.”
Fiona Osgun, head of health information at Cancer Research UK, said: "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. It’s important to remember that cervical screening is for people without symptoms so, if you notice any unusual changes for you, don't wait for a screening invitation - speak to your doctor."
For medical systems where GPs act as the front door to health care, such as the UK and Australia, the researchers suggest that offering a self-sampling kit during an appointment would be an effective way of encouraging more women to participate in cervical screening.
Each year in the UK 3300 women are diagnosed with cervical cancer. Estimates suggest that the number would be 5000 higher if it were not for cervical screening. In the past, 80% of women participated in cervical screening, but that number has been falling. In 2024 only 66% of those eligible for screening were up to date.
* Calculated as follows: Currently 3,300 cases a year in the UK. 71% of women aged 25-64 have been screened in the last 5 years; and 15% have not been screened in the last 15 years. If we assumed that regular screening reduces the risk by 90% and irregular screening by 50%, then without screening there might be 11,340 cancers. Of these 1700 would be in women not screened in the last 15 years. If half of them were screened and that reduced their risk by 80% that would be 680 cancers prevented. The 14% last screened between 5 and 15 years ago, contribute some 790 cancers. If half of these women were screened and their risk was reduced by 80% that would be a further 316 cancers prevented. Totally 996 prevented.
Anita WW Lim, Rebecca Landy, Jane Rigney, Bernard North, Peter D Sasieni. Impact of mode of offer of self-sampling to people overdue cervical screening on screening participation: a randomised controlled trial. eClinicalMedicine. 28 July 2025. DOI: https://doi.org/10.1016/j.eclinm.2025.103357