HPV testing kits are not smear tests

“Over 31,000 women will be offered kits to carry out smear tests in the privacy and convenience of their own homes in a trial.”

Matt Hancock, 24 February 2021

The Health Secretary Matt Hancock tweeted that 31,000 women will be offered kits to carry out smear tests at home, as part of a new trial. What he was actually describing are home HPV testing kits. The NHS press release he shared alongside the tweet also made the same error by describing these as “smear tests”. 

What is the difference between a HPV swab and a smear test?

HPV testing kits and smear tests are not the same thing. 

A smear test (also known as a cervical screening test) uses a small brush to take samples of cells from the cervix, and can help to detect early signs of changes to the cells which could lead to cervical cancer. This test requires examination with a speculum and is performed by a medical professional who is trained in how to do smear tests. It would be near impossible to perform on yourself.

Under the current UK cervical screening programme, the sample is then tested for (Human papilloma viruses (HPV). If HPV is not found, no further testing of the sample is required on that occasion. If HPV is found on the sample, then the cervical cells will be further analysed. On the basis of the appearance of the cells you may be offered more frequent smears, or further testing. 

The YouScreen trial announced by Mr Hancock, refers to a different process, which offers swabs to test for HPV which can be done at home and without assistance.  

The distinction is important, because if the HPV test is positive, the person being tested will also need to have a traditional smear test. This will ensure that the cervical cells are examined to look for any early signs of changes which could lead to cervical cancer. If people think that the HPV swabs are smear tests, they may not understand the importance of attending for a smear if they are asked to. 

Human papilloma viruses are a group of common viruses. There are over 200 types, most of which are harmless. However, some types of HPV can cause genital warts, and others are known to cause different types of cancers. Almost all cases of cervical cancer (99.7%) are linked to high-risk types of HPV.

Dr. Edward Morris, President at the Royal College of Obstetricians and Gynaecologists (RCOG), told Full Fact: “We want to stress that the new at-home screening kits being trialled in England are not a replacement for the traditional smear tests which are carried out by a healthcare professional.” 

“The self-sampling kits will be testing for the HPV virus and it’s hoped that by introducing these kits as part of the cervical screening programme, it will make screening more accessible to all women and increase uptake.”

He added: “The RCOG fully supports calls to introduce HPV self-sampling kits and believes it will encourage more people to be screened and therefore be identified for follow up care. We know that uptake for cervical screening tests is particularly low in deprived populations and those with a high proportion of ethnic minority women  [...] and this initiative could address this.”

Dr. Annabel Sowemimo, Sexual and Reproductive Health registrar and founder of the collective Decolonising Contraception, said the description of the HPV test kits as “smear tests” had “confused a lot of people”. 

“I think it’s really vital that when a new public health intervention is launched, we really try our best to get the wording absolutely spot on. It’s a shame that this has distracted from what may actually be a vital step towards improving early diagnosis of precancerous changes for cervical cancer.” 

“It’s a simple swab much like the self-swabs for other STI screening - it should not induce the fear that some experience when a smear or speculum is mentioned.”