Women who are too anxious or embarrassed to go for a smear test could instead provide a urine sample to be screened for cervical cancer, research* suggests.
In trials urine testing was found to be as good at detecting HPV as a conventional smear. While more work is needed researchers said self-testing could totally change women’s' attitudes to smears and address declining uptake.
The number of people going for smear tests is lower than ever in the UK. NHS figures show attendance is now down to 71%, meaning several million women across England have not had a smear test for at least three and a half years.
Pilot studies are already asking women to try out self-testing at home with a vaginal swab. But researchers at the University of Manchester writing in BMJ Open say urine testing would be another option.
They asked 104 women attending a colposcopy clinic to try the urine test and it performed just as well as conventional smears for detecting high-risk HPV.
Lead researcher Dr Emma Crosbie told the BBC: "We're really very excited by this study, which we think has the potential to significantly increase participation rates for cervical cancer screening.
"Campaigns to encourage women to attend cervical screening have helped. The brilliant campaign by the late Jade Goody increased numbers attendance by around 400,000 women.
"But sadly, the effects aren't long lasting and participation rates tend to fall back after a while. We clearly need a more sustainable solution."
She said larger trials of the urine test were still needed before it could be recommended to the NHS.
Athena Lamnisos, from the Eve Appeal, a charity which raises awareness of gynaecological cancers, said: "Finding ways of screening that avoid the need for a physical test and use of a speculum is important.
"For women living with the impact of FGM [female genital mutilation] or those who have suffered sexual abuse or live with conditions such as vaginismus, screening in a non-invasive way could be game-changing for screening uptake.
"This research sounds like a promising early step but is some way off being rolled out through the NHS.
"In the meantime, women must continue to book their screening appointment when they're called. It's a life-saving test."
*Sargent A, Fletcher S, Bray K, et al. Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. BMJ Open 2019;9:e025388. DOI: 10.1136/bmjopen-2018-025388