Feature Medical Screening

Smear fears

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2830 (Published 14 June 2010) Cite this as: BMJ 2010;340:c2830
  1. Margaret McCartney, general practitioner
  1. 1Glasgow
  1. margaretmccartney{at}doctors.org.uk

    Is the new DIY alternative to the smear test a valuable addition to screening or will it result in unnecessary expense and worry? Margaret McCartney investigates

    Women can now test themselves for cervical cancer without having to see a nurse or doctor. A new do it yourself test has been launched by online medical company Dr Thom, which also deals in hair loss, impotence, and sexually transmitted infections. The company offers a test in the form of a tampon that can be inserted at home. It is an “accurate and painless way to check yourself for precancerous changes in the cervix,” the company says, “so that you can do something about it before it is too late.”

    The test uses mRNA to detect cervical cells infected with human papillomavirus (HPV), and results are reported as positive, negative, or inconclusive—in which case the test will be repeated free of charge. A free telephone consultation is also available to discuss the results. So is this a patient centred advance that will improve uptake of cervical screening or is it an expensive test (it costs £115 (€136; $167)) that is unproved and likely to result in more unnecessary tests and procedures?

    Thomas Van Every, medical director of Dr Thom and part time clinical assistant in genitourinary medicine at the Chelsea and Westminster Hospital is enthusiastic about the new product. “We know that HPV infection causes the majority of cervical cancer. We know that cytology has a low specificity—it’s good at picking up abnormalities, but it also ends up shunting a lot of healthy women into the …

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