Table 2

Recommended evidence for healthcare practitioners to address with patients concerned about cervical screening programme changes

Concerns expressed in online petitionEvidence-based responses to concerns
Concerns about the sensitivity of HPV testingHPV testing has increased sensitivity compared with Pap smear testing8 and so has the potential to detect more cervical abnormalities than cytology-based screening.
Concerns about 5-yearly screening intervalIncreased sensitivity of the new HPV screening test compared with cytology to detect precancerous cervical abnormalities and cervical cancer means that screening can be less frequent while still detecting almost all cervical abnormalities.8
Risk of cervical abnormalities over 5 years is lower for an HPV-negative finding than a negative result from cytology over a 2-year or 3-year interval.
HPV testing can identify women at risk often before cell changes occur, whereas Pap smears detect changes to cervical cells after they have occurred.
Concerns about later age of first invitation to screen (25, as opposed to 18 previously)Most cervical abnormalities in women under the age of 25 years tend to regress by themselves, so testing early may lead to unnecessary invasive procedures.10 In women under 25 years, the harms are likely to outweigh the benefits of screening (eg, unnecessary invasive procedures that can cause complications) and starting screening at 25 years will reduce the number of investigations in this younger age group.
Incidence and mortality of cervical cancer in women under 25 years is very low, and this has not changed since the introduction of the screening programme.3
Young women are also offered the HPV vaccination, and this is expected to lead to a significant reduction in the risk of cervical cancer in this age group.
  • HPV, human papillomavirus.