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Last Updated: Wednesday, 22 October, 2003, 10:56 GMT 11:56 UK
Women to get 'better smear tests'
Cervical smear cells
The technique involves a new way of taking cervical samples
The NHS is to introduce a new test to check women for possible signs of cervical cancer.

The government announced 7.2m to fund the shift from traditional smear tests to a new technique called liquid-based cytology over the next two years.

The National Institute for Clinical Excellence had called for the existing tests to be replaced.

It says LBC is more reliable and will lead to fewer women being recalled for repeat tests because of errors.

'Inadequate smears'

Traditional Pap smears have been offered in England and Wales since 1989.

Around one in 10 of these smears are classed as "inadequate", which means there have been problems with the way the sample has been taken.

This new technique will reduce the numbers of women who have to have their smear test repeated
Melanie Johnson,
Public Health Minister
Women are then asked to go back for a repeat test, which can cause a great deal or worry and anxiety.

The LBC test, which will also be introduced across Wales, has an inadequacy rate of around 1.6%.

Pilot studies in four English hospitals have also shown the technique is better than Pap smears at picking up potential cancers.

Age change

The NHS Cervical Screening Programme also announced changes to the frequency of testing.

KNICKERS HELP WOMEN'S HEALTH
Knickers (image courtesy of Central Liverpool PCT
Health officials in Liverpool decided to use knickers to get the message across about the importance of women having a smear test.
Four in 10 women aged 25 to 29 in the city centre have not had a smear in the last five years - despite Liverpool's cervical cancer death rate being 53% higher than the national average.
Central Liverpool Primary Care Trust launched the 'Inside Info' campaign to raise awareness.
Margaret Evans, a senior nurse with the PCT, said: "We want to encourage women to take the smear test, which is quick, straightforward and painless."
Traditional smears are offered every three to five years to women aged 20 to 64.

But, under new recommendations, women will not be called for their first smear until the age of 25.

They will then be recalled for tests every three years until the age of 49, then every five years until the age of 64.

Experts said the changes would be costly.

But Professor Jack Cuzick, of Cancer Research UK, said: "It is heartening to see the NHS acting upon research recommendations so promptly.

"The evidence very strongly suggests that five-yearly screening is sufficient in older women, but that there is a clear additional benefit of more frequent screening in younger women.

"The adoption of these proposals will end the current postcode lottery, in which women are invited either three yearly or five yearly depending on where they live."

Less uncertainty

In Liquid-based cytology, samples are taken in the usual way but using a brush-like device rather than a spatula.

The head of the device is rinsed or broken off into a vial or preservative fluid so that most or all of the cervical cells are retained.

In a Pap smear, cells are taken from the cervix, or neck of the womb, using the spatula and then spread onto a glass slide which is sent to a hospital laboratory so specialists can spot abnormal cells.

Doctors and nurses who take the cervical samples, and laboratory staff who check them will have to be trained to use the new technique,

The test is already set to be made available to women in Scotland by April next year.

NICE estimates that switching to the new form of testing will cost up to 10.3m in England.

But Melanie Johnson said the government was committed to introducing the new technology.

"At the moment, up to 300,000 women a year have to have their smear test redone because it cannot be read properly.

"This of course causes real anxiety and uncertainty. This new technique will reduce the numbers of women who have to have their smear test repeated from 1 in 10 to 1 in 100," she said.

Andrew Dillon, chief executive of NICE, said: "At the moment, around one in 10 Pap smear tests have to be repeated, which is inconvenient for women and may cause unnecessary anxiety.

"The evidence we looked at on liquid based cytology showed that this method may result in samples that are of better quality and easier to read, reducing the number of tests that need to be repeated."

NICE did not recommend the use of one particular product saying there was "insufficient evidence" to show that one is better than another.

Shadow Health Minister John Baron MP said: "Any attempt to improve the detection and treatment of cancer is most welcome.

"However, without fundamental reform to the NHS, we will not see real improvements in outcomes."


SEE ALSO:
NHS smear test 'to be replaced'
19 Aug 03  |  Health
Guidance on smear frequency
02 Jul 03  |  Health
The future of screening
14 Dec 02  |  Health
Cervical and Uterine Cancers
17 Mar 00  |  C-D


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