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Researchers develop at-home alternative to smear test

A DIY swab and urine test could help women identify if they are at risk of cervical cancer, researchers say. 

The test, which may be able to detect cervical pre-cancer by analysing urine and vaginal samples that women can collect themselves has been called a ‘game-changer’ by a cervical cancer charity.

Researchers at Queen Mary University of London asked 600 women to provide self-collected samples, which they then screened for chemical changes which could indicate the presence of ‘pre-cancerous lesions’.

The findings, which were presented at the NCRI cancer conference in Glasgow, suggest the method is feasible and would likely improve participation in cervical screening programmes.

Dr Nedjai, senior research fellow and director of the Molecular Epidemiology Lab at Queen Mary’s Wolfson Institute of Preventive Medicine said:

‘The initial use of self-sampling is likely to be for women who do not attend clinic after a screening invitation and in countries without a cervical cancer screening programme.

‘In the longer term, self-sampling could become the standard method for all screening tests. The study indicated that women much preferred doing a test at home than attending a doctor’s surgery.’

Cervical cancer is the fourth most frequently occurring cancer in women in the world. In 2018, there were an estimated 570,000 new cases of cervical cancer and 310,000 women died from the disease.

The NHS is currently moving to primary human papillomavirus (HPV) screening of smears – testing for the presence of this virus in samples before looking for abnormal cell changes as almost all cases of cervical cancer are linked to HPV.

Dr Nedjai the HPV test is very good at detecting true positives but lacks specificity. This means a second test is needed to exclude HPV positive women that are not at increased risk of developing cancer.

Whereas the test developed by Dr Nedjai’s and her colleagues, known as the S5 test, measures chemical changes that are detectable in urine or self-collected vaginal fluid samples to gauge a woman’s cancer risk, with a high score suggesting an increased risk of a pre-cancer lesion being present.

Dr Nedjai described the results as ‘promising’ and said her team is now working to improve the test’s accuracy. She said:

‘We found that the S5 classifier with or without HPV testing worked well in both urine and vaginal samples. It distinguished between women who had no pre-cancerous lesions and those who had lesions.

‘We are currently working on new markers to try to improve the accuracy of the classifier even further, but these findings represent an advance in cervical cancer screening, especially for women who do not attend the clinic, such as older women, or women who find the smear test too painful or who do not have access to a screening programme in their country.

‘We think it’s promising.’

Robert Music, chief executive at Jo’s Cervical Cancer Trust welcomed the findings and said it’s vital that further research is conducted. He said:

‘The findings from this research could be a game-changer. It could mean those requiring treatment are identified faster and reduce the number of women having to go for potentially unnecessary investigations at colposcopy.

‘This would also save the NHS precious funds. It is vital that further research is conducted on larger groups of women however the findings are exciting and could mean that new methods for cervical screening are getting closer to reality.

‘For women who find the current methods of cervical screening difficult, including those with a physical disability or who have experienced trauma, it could mean they can access screening in a far more acceptable and accessible way.’

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