We Might Soon Only Need One Smear Test In Our Lifetime

But don't be cancelling your next cervical screening appointment just yet.
Could we have fewer pap smears in future?
Peter Dazeley via Getty Images
Could we have fewer pap smears in future?

Women and people who have cervixes may need to do only one smear test in their lifetime, thanks to the efficiency of the HPV vaccine, a new study suggests.

Currently, people over 25 are invited in for a cervical screening every three to five years.

But Professor Peter Sasieni, the director of the clinical trials unit at King’s College London, says the vaccine has worked so well and dramatically reduced cervical cancer, that not as many tests could be required in the future, particularly if a newer vaccine is used.

Girls aged 11 and 13 have been offered the vaccine since 2008 (and boys since 2019), before the age that sexual activity usually starts, a strategy that has been effective in decreasing risk. Research from December 2021 showed a 90% decline in cervical cancers for those who had the HPV vaccine.

HPV is the human papillomavirus, a type of virus that infects the skin and cells lining the inside of the body. It spreads through close skin-to-skin contact, usually during sexual activity including oral sex.

For most people, the infection will get better on its own, causing no problems. Many will never know they had it – but some types can cause genital warts or cancer.

A new HPV vaccine, Gardasil 9, is to be introduced in schools from September 2022, which protects against more types of the virus – a development that Prof Sasieni called “really exciting”.

“I think with that probably one screen would be enough, maybe two, over a lifetime,” he told Inside Health on BBC Radio 4, suggesting 30 and 45 as the key ages it would be needed.

But it’s worthwhile remembering that Dr Sasieni is talking about this newer version of the vaccine. Karen Hobbs, Ask Eve service co-ordinator at The Eve Appeal, a charity that researches gynaecological cancers, stresses that it’s important to carry on going for your regular smear tests for now.

“The suggestion of potentially having only one cervical screening test in someone’s lifetime is not relevant to any women or people with a cervix who have already had the HPV vaccine and/or are currently receiving three to five yearly cervical screening tests from 25-64,” she tells HuffPost UK.

“This is a comment from a scientist in relation to the possibilities in the future around screening pattern/programme, if the new vaccine is successful and we keep seeing improvements in the reduction of cervical cancer cases and HPV.”

The current vaccine protects against the four types of HPV (6, 11, 16 and 18). HPV 16 and 18 – are the high-risk types with the potential to cause cancer, and are responsible for around 70% of all cervical cancer cases.

The Gardasil 9 vaccine, which will be offered to children in year 8 from the coming school year, will protect against an additional five types of high-risk HPV (31, 33, 45, 52, and 58) that are responsible for another 20% of cervical cancers.

“We know that the HPV vaccine is successful, and vaccinating against a further five types of high-risk HPV, implies an even higher reduction in cases of cervical cancer,” says Hobbs.

“But, we need to wait for studies to be done to look at the impact of Gardasil9, before any changes to screening intervals/the number of screening tests offered to someone. Evidence needs to be there, to show it’s safe for this to happen.”

Hobbs adds: “We also hope that the conversation around high-risk HPV continues to move away from just being a ‘girl’s problem’ and only discussed with regards to cervical cancer. Since 2019, boys have also been offered the vaccine as, yes, HPV is responsible for over 99% of cervical cancers, but it can also cause vulval, vaginal, anal, penile and head and neck cancers.

“Including all children in the vaccination programme and everyone in the conversation about HPV is welcomed and needed.”