 Cervical smear cells under microscope |
A new technique could soon be used to test women for cervical cancer. The NHS watchdog, the National Institute for Clinical Excellence, has recommended that the traditional cervical smear is replaced by liquid-based cytology.
Its experts say the newer technology is better at picking up potential cancers.
The proposals are out for consultation and a final decision on whether to introduce the new screening test is expected to be made next month.
Millions tested
Women in England and Wales have been offered Pap smears to test for early signs of cervical cancer since 1989.
The test is offered to every woman between the age of 20 and 64, every three to five years. Approximately 3.9m women are tested in England each year.
The Pap smear is usually carried out by a GP or nurse. Cells are taken from the cervix, or neck of the womb, using a disposable spatula which is then spread onto a glass slide. The slide is then sent to a hospital laboratory where it is examined by a specialist. They try to spot abnormal cells.
However, studies have suggested that as many as one in 10 of these tests is inadequate.
Scientists are often unable to analyse them properly because of problems with the way the cells are collected.
This has meant that women have had to be called back for a second test. This means extra work for NHS staff and increased anxiety for the women involved.
Experts at NICE believe that changing to liquid-based cytology will be better for everyone.
The test is already available in some parts of Scotland and will be available to all women there by April next year.
Liquid-based cytology is a relatively new way of testing for cervical cancer.
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.
More effective
Pilot studies in four English hospitals show the technique is better than Pap smears at picking up potential cancers.
They also showed it could reduce the rate of inconclusive smears by 6% a year.
This has prompted NICE's appraisal committee, which decides whether new technologies should be made available on the NHS, to recommend that it replaces Pap smears.
In a report, it states: "It is recommended that liquid-based cytology is used as the primary means of processing samples in the cervical screening programme in England and Wales."
The committee did not recommend the use of one particular product saying there was "insufficient evidence" to show that one is better than another.
But it added: "The NHS Cervical Screening Programme and Cervical Screening Wales may wish to consider evaluating further the different products as the method is introduced."
NICE has given interested parties until the beginning of September to appeal against its decision.
A spokeswoman for the NHS Cervical Screening Programme declined to comment.
She said officials would wait to see what NICE's final guidance will be.
Anne Szarewski of Cancer Research UK welcomed the move.
"I am very much in favour of liquid cytology. If it does nothing other than reduce the number of inadequate smears then it will be very much worth it," she told BBC News Online.
"That means women will not have to go back to have the test again. This will save money but more importantly it will get rid of the anxiety they suffer.
"Many of these women are convinced that there is something we aren't telling them and that there is something wrong. To get rid of that anxiety will be worth it on its own."
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If it does nothing other than reduce the number of inadequate smears then it will be very much worth it 
