Introducing a nationwide self-sampling programme for cervical screening could help remove barriers to testing and improve access for under-served groups, according to a new study by experts at the University of Manchester.
The research, published by Policy@Manchester, highlights how self-sampling methods—such as vaginal swabs or a newly developed urine test—could help tackle disparities in screening uptake. The authors argue that a national rollout of these alternatives could support government efforts to address health inequalities and ensure more people benefit from early cancer detection.
Addressing Declining Screening Rates
Cervical cancer accounts for 2% of all new cancer cases in UK women, affecting more than 3,000 people annually. While the incidence of the disease has declined since the 1990s, the report notes that screening coverage has also fallen, particularly since the COVID-19 pandemic.
Routine screening—commonly referred to as the ‘smear test’—is performed using a speculum and remains the most effective method for detecting and treating cervical abnormalities before they develop into cancer. However, the research found that many women face significant barriers to attending their appointments, particularly those from socioeconomically deprived backgrounds.
Patient Concerns Over Current Screening Methods
The University of Manchester study involved 46 participants from Greater Manchester, who shared their attitudes towards cervical screening and their experiences of the current system.
The researchers—Stephanie Gillibrand, Caroline Sanders, Emma Crosbie, and Jennifer Davies—found that negative past experiences were a major reason for avoiding screening.
“Pain and discomfort were common concerns, with many participants citing the speculum as a key factor in their reluctance to attend future screenings,” they wrote.
Women from ethnic minority backgrounds and those with mental health conditions also reported experiencing a lack of empathy from healthcare professionals and feeling rushed during appointments.
Despite these challenges, the study also highlighted positive experiences, particularly when healthcare professionals took time to make patients feel comfortable and explain the procedure clearly.
Support for Self-Sampling Alternatives
Participants in the study widely welcomed self-sampling alternatives, which involve collecting samples using a vaginal swab or urine test, without the need for a speculum.
“These methods were seen as more accessible, less invasive, and less stressful than traditional screening,” the researchers said.
They also found that offering self-sampling at home increased participants’ sense of control and autonomy, making it a more practical and convenient option.
Call for a National Rollout
The authors describe cervical screening as an essential tool in the fight against cervical cancer and argue that making it more accessible will help reduce the burden on the NHS and improve health outcomes.
“It is vital that screening is made as accessible as possible,” they concluded. “A nationwide self-sampling programme would help fulfil government commitments to tackling health inequalities and ensure that those most at risk receive the care they need.”
