At-home smear tests rolled out on the NHS from TODAY – here’s what happened when I did mine in the office loo

From today, DIY smear tests will be sent out to four million women across England who have failed to turn up to their in-person appointment in a bid to boost cervical cancer screening uptake and save lives.

Having tried it myself – I was one of 27,000 British women who used it as part of a trial – I think it’s a brilliant idea.

It could not have been quicker or simpler. In fact, I did mine in around two minutes, in the office loo, during my morning coffee break.

And like NHS health chiefs, I am convinced if all women had the option, it would increase numbers taking these tests — something that’s absolutely needed.

Currently in the UK, women aged 25 to 64 are invited for cervical screening at their GP surgery every five years, unless they are considered high risk.

The traditional method involves lying, naked from the waist down, with your legs up as a nurse inserts a tube-shaped instrument called a speculum into the vagina.

This allows them to see the cervix — the opening to the uterus — and take a sample of cells from it, which are then tested for human papillomavirus virus, or HPV, which causes 99 per cent of cervical cancers.

I don’t mind it, personally. It’s vaguely uncomfortable but not a problem. However, I have friends who find it painful.

But more importantly, screening uptake overall isn’t great. Only about 60 per cent of eligible women turn up for their scheduled test.

Embarrassment is a factor, according to research by cervical cancer charities. This can be particularly as issue for women from certain cultural backgrounds.

But for half of the no-shows every year, getting time off work and finding a convenient time to fit in an appointment are the reasons they miss it.

The new DIY approach will effectively tackle all these issues at once.

In what has been hailed as a ‘gamechanging’ next step towards eliminating cervical cancer, eligible women will start receiving invitations today via the NHS App, text message, email or letter.

Once invited they will be able to order az free kit through the NHS App or their NHS online account.

The self-testing kit contains a swab, similar to a long cotton bud, which is used to collect a sample from the vagina. The sample is then posted back to the NHS for free, where it is checked for high-risk HPV.

If high-risk HPV is found – the type that can develop into cancer – individuals will be invited to book a follow-up cervical screening appointment at their GP surgery or sexual health clinic, where a nurse or doctor will take a small sample from the cervix to check for cell changes.

 The trial I took part in was one of the very first to test the appetite for the technology, run by scientists at King’s College London, in partnership with NHS England. 

I volunteered to try the test, to see if it’s as easy as they reckon it is.

And, I must admit, I did a little shudder when I decided to take on this assignment. 

Like most girls, at school we were instructed to do ‘the mirror test’ – where you sit on the floor with your legs bent, hold a mirror out in front of you and familiarise yourself with your own anatomy.

 The exercise is designed to help you spot unusual changes. But I didn’t do it.

Let’s just say, it’s not an activity I’ve ever felt compelled to dedicate time to. And I did feel apprehensive, not least at the prospect of having to ‘dig around’ for a sample.

But I had no reason to worry — for a start, there’s no speculum involved.

The kit comes in a little box and consists of a swab housed in its own little plastic screw-up test tube-type-thing.

I took this, along with the instructions — which looks like something that might be handed out in a sixth-form sex-education class — off to the toilet.

You take the swab and push it into the vagina, about as far as you would to insert a tampon, twist it around for 20 seconds, pull it out, put it in a test tube pot and pop that in the post to go off for analysis.

There’s no pain or discomfort, just 20 seconds of ever-so-slight scratchiness — again, similar to removing a tampon.

The method is so idiot-proof that, according to studies, less than one per cent of women fail to do it correctly. 

The innovation has been made possible by a change in the type of test used in cervical screening.

Dr Anita Lim, lead researcher on the study I took part in at King’s College London, told me: ‘Traditionally, smear tests have involved taking samples of cells specifically from the cervix, which are then examined.

‘And the person doing the smear test needs a speculum to move other bits of the anatomy out the way, to find it.’

 But since 2019, doctors have moved towards first testing for HPV.

The virus is transmitted during sexual activity and is basically endemic. Up to eight in ten of the population, both men and women, are thought to be carrying it at any given moment.

Most of the time, it’s totally harmless. But a handful of the 150 strains can, in some cases, invade the genital tract where it causes cells to mutate and turn cancerous.

The virus can be found throughout the vaginal canal, so taking a sample is easy.

If a smear comes back positive for high-risk HPV, further tests are carried out to flag up if there really is a cancer risk and whether treatment is needed.

Around the same time the London trial was launched back in 2021, the results of Scottish trials showed that DIY tests — also known as self-sampling — were as accurate as the in-clinic test.

And, like me, medics welcome the proposed rollout.

As Dr Adeola Olaitan, a consultant gynaecologist at University College London Hospitals NHS Foundation Trust, said: ‘For years, campaigners have been asking why don’t we just let women swab themselves.

‘They’ve done it for years in other countries such as Denmark and Australia. Covid sort of revved everything up a gear.’

‘This is the future of women’s healthcare – more choice, more freedom,’ says Dr Lim. ‘It removes the invasiveness and embarrassment and, instead, empowers women to protect their own health. 

‘There’s plenty of robust evidence to show this works, so it was only a matter of time before it became available to NHS patients.’ 

With the DIY test women will miss out on the visual examination that happens at the GP surgery.

Looking at the cervix is useful for spotting other abnormalities that may remain undetected, such as infections or non-cancerous growths called polyps.

But these so-called incidental findings are spotted in only seven per cent of appointments, according to studies.

It’s also important to note, that a positive HPV test result doesn’t mean have or are going to get cancer.

‘HPV is very common in women under 25, and it’s extremely rare for it to develop into cervical cancer,’ says Dr Jo Waller, an expert in cervical cancer prevention at King’s College London.

‘In young women, HPV usually goes away on its own and causes no problems. Some people liken it to a cold for the genitals.

‘More often than not, the immune system clears it up and you’d never know you’d had it.’

Roughly 20 in every 100 women have what’s known as a tilted uterus – where the uterus hinges slightly backwards where it meets the cervix, rather than forwards.

In these cases, having a speculum inserted can be very painful. But experts say these patients will benefit from the DIY test, too.

‘The beauty of this test is it doesn’t force women into an uncomfortable position,’ says Dr Olaitan.

‘You don’t have to see the cervix to get the sample. And there’s no lying down on a bed — you can do it in whichever position is easiest.

‘Basically, anyone who can insert a tampon can take their own swab.’

Speaking of the roll out, Dr Sue Mann, national clinical director for women’s health at NHS England, said:

‘Offering millions of women an alternative test they can do from the comfort of their own homes will be a gamechanger – making it easier than ever for them to get tested for HPV.

‘If you’re invited to take part, please order a test – it’s a simple swab you can do at home in minutes.’

Meanwhile, Health and Social Care Secretary Yvette Cooper added: 

‘Cervical cancer is preventable – but that’s why we want to make it as easy and convenient as possible for women to keep up with their screening.

‘These free self-testing kits will be offered to four million women who are currently behind on their screening to make it easier for as many women as possible to keep themselves healthy and safe.

‘This is the future NHS we are building – there for all of us when we need it, and acting as early as possible to stop preventable deaths.’

Cervical screening appointments with a clinician remain the best way to help prevent cervical cancer, but HPV self-testing is being introduced by the NHS as an additional choice, experts say.

A few days after my self-test, the result came through.

In truth, I already knew what it’d say, as I’d had a normal smear test two weeks previously: Negative – hurrah.

Still, I appreciated the reassurance. And all it took was a two-minute trip to the toilet.