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Cancer Prevention Group

Projects

Cervical Screening & HPV Control

Funding Body:  Cancer Research UK

Project Investigators:  Peter Sasieni, Anita Lim

Overview

Self-sampling for HPV testing in primary care

Self-sampling for HPV (human papillomavirus) testing can overcome many of the barriers associated with cervical screening, including embarrassment, discomfort and the need to attend appointments.

It enables women to take a sample at a time and place of their choosing, without a pelvic examination. Although there are drawbacks in test performance, these would be offset by the increase in screening coverage.

Various approaches have been studied including sending self-sampling kits directly to women or asking women to order kits over the phone. Response rates have been variable (8.7-52.1%) and it is unclear what the most effective approach is. Although GPs and nurses offer vulvo-vaginal self-testing kits opportunistically as part of the National Chlamydia Screening Programme, such an approach has not been evaluated for cervical screening non-attenders.

It has the advantage of in-person contact with a population who are difficult to engage and fewer wasted self-sampling kits because they are handed directly to women.

Given the busy and complex clinical setting of GP primary care, we are carrying out a pilot study to determine the feasibility and acceptability of offering self-sampling to non-attenders in primary care. The pilot will serve to address practical and logistical issues and will help streamline the design for a larger randomised trial.

Other projects include: Novel cervical screening technologies and DNA methylation as a biomarker to detect high grade anal intraepithelial neoplasia.

Main Contact: Anita Lim

Email:  anita.lim@kcl.ac.uk

Phone: 020 7848 5494

Cervical Screening Audit

Funding Body:  Cancer Research UK and NHS Cancer Screening Programme

Project Investigadors: Peter Sasieni, Alejandra Castanon

Overview

This project collects the cervical screening histories of all women diagnosed with cervical cancer in England and Wales (with estimated 95% coverage) together with details of at least two randomly selected controls per cancer case. Additionally slide review (of both cytology and histology) is conducted on all slides within 10 years of diagnosis. The database currently includes over 11,000 women with cervical cancer.

We publish an annual report and statistical summary.

Additionally, the audit has led to several publications which have provided evidence on which to base Cervical Screening policy and guidelines.

Main Contact: Alejandra Castanon

Email: alejandra.castanon@kcl.ac.uk 

Phone: 020 7848 5422

Evaluation of HPV Primary Screening Pilot

Funding Body:  NHS Cancer Screening Programme

Project Investigators: Peter Sasieni, Matejka Rebolj

Human papilloma virus (HPV) testing as a primary screening method is expected to be more sensitive than cytology, and by virtue of extending screening intervals and use of less manpower, may be more cost effective.

A pilot of HPV testing as primary screening is now to be implemented in six sites in England. These sites previously acted as sentinel sites for HPV triage of women with borderline/mild cytology, which is currently being rolled out throughout the NHS Cervical Screening Programme (NHSCSP).

The sites will follow the protocol agreed by the NHSCSP HPV Primary Screening Pilot Group

The aims of the evaluation of the pilot are to study the effect of the introduction of HPV primary screening on key outcome measures including uptake/coverage of cervical screening, rates of referral to colposcopy, rates of compliance with recall and detection rates of disease.

Main Contact: Matejka Rebolj 

Email: matejka.rebolj@kcl.ac.uk 

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