Cervical Screening: The left lateral test position
Research type
Research Study
Full title
Increasing engagement and improving patient experience of cervical screening in primary care: Implementing the left lateral test position. A realist evaluation and implementation study.
IRAS ID
327564
Contact name
Nicola Walsh
Contact email
Sponsor organisation
University of the West of England
Clinicaltrials.gov Identifier
researchregistry10385, Research Registry
Duration of Study in the UK
2 years, 1 months, 30 days
Research summary
Cervical screening is important to detect a virus or cell changes that may lead to cancer. People with a cervix are invited for testing from age 25-64, or when previous abnormal results are found. Traditional testing requires the patient to lie on their back with knees bent up and apart so the clinician can take a swab sample. Some people report they find the test degrading, embarrassing, anxiety provoking and uncomfortable. Also, people who have experienced sexual trauma report the test makes them feel vulnerable, and in women who for cultural reasons have genital circumcision, exposing their body parts leads to embarrassment and anxiety. These issues contribute to the reducing numbers attending screening. In 2020 national guidelines included the new left lateral test position (LLTP), and all people who attend cervical screening should now be offered both positions. In the new position the patient lies on their left side with their legs slightly apart. The LLTP is as effective, is less exposing and may be more comfortable, which may encourage more people to attend screening. However, research has shown that patients are not aware of this position and clinicians are not offering it. We aim to investigate whether providing information about screening choices, and supporting practices to implement the LLTP improves uptake and experience of cervical screening. There will be 3 phases including co-design workshops to create information about screening choice and to determine how people would like to receive information; evidence review and focus groups to develop understanding of how LLTP may work in practice; and working with 13 GP sites over a 6-month period to test whether supporting them to inform patients of their screening choices, and helping clinicians to offer the new position, encourages more people to be screened, choose their position and improves patient experience.
REC name
London - City & East Research Ethics Committee
REC reference
25/LO/0273
Date of REC Opinion
7 May 2025
REC opinion
Further Information Favourable Opinion