By Dr Mairead O’Connor, Research Officer, National Screening Service
We’ve completed research to examine the outcomes for women who have repeat HPV cervical screening tests following an initial HPV found result with no abnormal cells detected.
In 2020, we introduced an increased surveillance pathway for women who have HPV found but have no abnormal cells found. These women are called back after one year for another HPV test.
Women who have no HPV found after a repeat test are returned to routine cervical screening while those who have HPV found (persistent HPV) are referred to colposcopy.
What we did
We reviewed data on repeat HPV tests and outcomes for the first two years of this new surveillance pathway. We used two timeframes:
- Year 1 – 1 April 2021 to 31 March 2022
- Year 2 – 1 April 2022 to 31 March 2023
Only women in the cervical screening age range (25 to 65 years) were included in the study.
What we found
- 88% of women advised to attend for a repeat HPV test in the first year attended within 15 months.
- 9,638 repeat HPV tests were performed in Year 1, with 15,849 performed in Year 2.
- 55% of women had HPV found after a repeat test (persistent HPV). This was higher in Year 1 (57.7%) than in Year 2 (53.5%).
- 17.9% of those who had HPV found in Year 1 had low-grade abnormal cells detected. This was higher in Year 2 at 20.7%.
- 2.4% of those who had HPV found in Year 1 had high-grade abnormal cells detected. This was higher in Year 2 at 2.6%.
- The rates of women who had HPV found and who had low- and high-grade abnormal cells detected was higher among younger people and declined with age.
What this tells us
This data provides useful insights on follow-up for women who initially have HPV found but have no abnormal cells found. In women who have repeat HPV tests after 12 months, 55% have persistent HPV and are referred to colposcopy. CervicalCheck is monitoring these outcomes with a view to considering the 12-month recall time, as evidence from the UK shows that a 24-month recall time leads to increases in reported clearance of HPV, and less referrals for unnecessary colposcopy investigation.
- This research was presented by Dr Mairead O’Connor, Research Officer, National Screening Service at the BSCCP annual scientific meeting in Edinburgh in April 2024.
- We’ve published our CervicalCheck programme report for the period 1 April 2020 to 31 March 2022. This is the first CervicalCheck programme report to be published since the introduction of primary HPV cervical screening in 2020.
- We’ve published research showing the early signs of the positive protective effect of HPV vaccination in women at the time of their first cervical screening test.
- Cervical cancer could be the first cancer ever to be eliminated globally. Ireland is on track to eliminate cervical cancer by 2040.