It has recently been announced that 31,000 women are expected to trial ‘do-it-at-home’ smear  test kits for the NHS, replacing the in-person test one would usually expect. Coined as ‘a game changer’ by Dr Anita Lim, I would argue this to be a huge step taken towards improving women’s health. However, it is crucial to recognise the flaws in this policy, which has already seen Health Secretary Matt Hancock – quite rightly – receive a fair amount of backlash.

Introduced as a response to delays caused by multiple lockdowns, the accessibility of home kits is something I would commend as revolutionary. It encourages women to take the often intimidating test and will likely save more lives. Even in a pre-Covid world, missed appointments and delays were not an uncommon occurrence. Women have often dismissed the need for a smear test for a multitude of reasons such as cultural barriers, experiences of sexual abuse, fears of discomfort and even general embarrassment. With the implementation of home testing kits, I believe this will encourage women to be more vigilant when testing themselves, as they can do so from the comfort of their own homes. 

Here comes the big ‘but’ though. The home kit provides a self-sampling swab which will be used to test for human papillomavirus, or HPV, in the vagina, not the cervix – therefore failing to replicate the procedure entirely. While the presence of a speculum, stirrups and a doctor equipped with an examination light is certainly intrusive, it is essential in confirming any threats to a woman’s health. Therefore, I find it largely disappointing that the Health Secretary is so unaware of what a smear test actually requires, particularly when it impacts such a vast majority of the population. Nicola Thorp’s satirical article on the matter jokes on Hancock’s unawareness of what a smear test actually requires, mocking ‘Same genitalia, different components – but it wouldn’t be the first time a man had struggled to locate a specific part of the female anatomy.’

The organisation ‘Jo’s Cervical Cancer Trust’, thankfully, provided the explanation that ‘self-sampling tests are actually completely different from the cervical screening test you would have at the GP…The sample is tested for HPV, the virus which causes almost all cervical cancers, this means if you do not have HPV your risk of cervical cancer is very low.’ While I find it to be largely concerning that the Health Secretary is so uninformed on a matter that affects 50% of the population, women’s ability to take these swabs themselves ultimately avoids the embarrassment factor that may have deterred them in the first place. If these results show any risks to their health, perhaps they will be more willing to follow up their results and go through with the traditional smear test procedure.

An estimated 600,000 tests failed to go ahead in the UK between April and May 2020, in addition to the backlog of 1.5 million appointments recorded to have been missed annually. Cervical cancer kills around 850 people every year but with something as simple as a smear test being able to prevent this, then, the general lack of engagement should not be overlooked. Dr Lam suggests ‘We know many women aren’t coming forward for screening and almost half of women in some parts of London aren’t up to date with their cervical screening.’ If the intimate nature of the test is what prevents some women from feeling comfortable enough to attend these appointments, then – as previously mentioned – I feel the introduction of home testing kits will have a positive influence on the numbers of women engaging with them, allowing them to complete the potentially life-saving  test while maintaining their privacy. 

While it is true a simple swab is not enough to replicate a qualified nurse performing the procedure, I feel this concern is outweighed by the positive impact this could have on the number of women participating in these tests. Though Cancer Research UK has stated that it is not yet sure how effective or accurate self-sampling would be in cervical screening, I would certainly advocate that this is a step in the right direction – regardless of how big or small of a step it turns out to be. If these swabs are successful in picking up a presence of HPV in the vagina, I believe this would act as a push in convincing women to recognise the importance of smear tests, even if home kits don’t replicate the traditional test entirely. Particularly at a time of strain for the NHS, I feel we should look upon this with great hope and optimism for the future of testing and diagnosis.

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