ACES Over 65's
Research type
Research Study
Full title
Alternative CErvical Screening (ACES) Over 65's
IRAS ID
309115
Contact name
Emma J Crosbie
Contact email
Sponsor organisation
The University of Manchester
ISRCTN Number
ISRCTN39388293
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Cervical screening can save lives from cervical cancer, yet only 7 in 10 women in the UK attend screening, the lowest rate in 20 years. Reasons include embarrassment, fear of speculum examination and inconvenience. Poor attendance is highest amongst women at greatest risk of cervical cancer, including smokers from socio-economically deprived backgrounds. Cervical screening is offered to women aged 25-65 years in the UK, stopping at 65 years partly for historical reasons and partly because speculum examination is uncomfortable for elderly women. Yet deaths from cervical cancer are highest amongst women aged >70 years, particularly those who haven’t attended cervical screening previously. For these reasons, several countries across Europe and Australia have now extended their cervical screening programmes to women aged up to 79 years.
Cervical screening is carried out by collecting cells from the cervix (neck of the womb) with a soft brush. These cells are tested for a virus known to cause cancer called human papillomavirus (HPV). If HPV is detected, the cells are examined under the microscope. If they look abnormal, the woman is referred to colposcopy clinic, where cells that are found to be ‘pre-cancerous’ (cells with potential to become cancer cells) are identified and treated. To increase screening rates, vaginal ‘self-sampling’ has been tried, where a woman collects cells from her vagina at home and returns the sample by post, however only 1 in 10 women return the sample. There is therefore an urgent need for new ways to reverse declining rates of cervical screening.
We have developed a urine test that can detect HPV. This test has the potential to remove many of the current barriers to screening and could substantially increase the number of women attending. This study will offer a urine HPV test to women aged 65 years and older who have exited the cervical screening programme and are attending a Manchester University NHS Foundation Trust (MFT) community-based lung cancer screening service for current and ex-smokers. It will see if (1) a one-stop-shop that combines cervical and lung screening is feasible; (2) urine HPV testing encourages high risk non-attenders from underserved communities to be screened; and (3) the prevalence of HPV in women >65 years justifies a reappraisal of arbitrary, non-evidence-based age cut-offs for cervical screening.
Funding is provided by MAHSC.REC name
London - Fulham Research Ethics Committee
REC reference
22/LO/0041
Date of REC Opinion
9 Feb 2022
REC opinion
Further Information Favourable Opinion