Could your next smear test be done at home?

Regular cervical screening (also known as a smear test) is vital for cancer prevention, yet nearly a third of women in England haven't gone for their most recent test when offered, according to the most recent NHS Cervical Screening survey.

Being too busy to attend an appointment, or having trouble booking one at all, are among the reasons given, but a common deterrent is people finding the examination anxiety-inducing, painful or embarrassing.

In recent years, at-home self-tests have been developed and a few big trials have been run recently with positive results. But at-home testing isn't yet available on the NHS. 

There are currently a few home HPV testing kits available to buy privately, so could these offer a solution? We asked the experts to help you decide what's right for you.

Eat well, live better, stay healthy – sign up to our free monthly food and health newsletter for the latest insights delivered straight to your inbox

Why should you test for HPV?

HPV (human papillomavirus) is a common virus that most people will get at some point in their lives, and in most cases the immune system will fight it off.

However, certain high-risk HPV strains are of more concern because they are responsible for nearly all cases of cervical cancer, which is the 14th most common cancer among women in the UK, and according to Cancer Research, the sixth most common cause of cancer deaths for the same group.

It's preventable through regular screening, and all women should be offered an NHS screening test every three years once they turn 25, and every five years between age 50 and 64. 

This is because these are the ages when you are likely to be most at risk. However, if at any time you have symptoms of concern you should see your GP – don't wait for a screening test.

At-home cervical screening: a game-changer?

Research commissioned by Healthwatch shows that women who are reluctant to have a smear test are keen on the idea of at-home self-tests, and a large-scale YouScreen / NHS trial in the UK, published in July 2024, found that giving women self-sampling HPV tests significantly improved screening rates, leading experts to say that these DIY HPV kits could be 'game-changing'. 

When you attend an in-person cervical screening, the health professional uses a speculum to widen the vagina before taking a sample using a long cotton bud-like stick, but with a home test you don't need to use a speculum. 

After taking your own sample using a long cotton bud or tampon, you either post it off for lab testing or, in some cases, wait for a result at home within 15 minutes (a bit like a Covid test).

There is another variant in development, the Papcup, supported by Cancer Research's innovation fund. This uses a sample of menstrual blood and means you don't have to insert anything into your vagina. But this is still a way off being available.

Self-test HPV kits have already been rolled out successfully in countries including Denmark, Australia and Switzerland, according to the YouScreen study, but they haven't been rolled out on the NHS just yet.

There are, however, some tests available to buy privately, typically costing £50-70. 

Does a home HPV test mean I can skip cervical screening?

While they are a promising development for those who are reluctant to otherwise get tested, the experts we spoke to cautioned against ditching in-person NHS screening for private tests.

An NHS cervical screening appointment isn't just about taking a sample – it also gives the health professional a chance to ask about any symptoms you may be experiencing and to check your vulva for any concerning signs.

Not only that, but if high-risk HPV is found, this will kick-start an entire care pathway to ensure you get further tests and treatment if needed. Your sample would be tested for cell changes that could go on to cause cancer (a Pap test).

Depending on your results you may then be invited to hospital for a colposcopy and possibly a biopsy to take an even closer look and decide next steps.

Home cervical screening is promising but there are drawbacks

Although the YouScreen trial is encouraging, experts say the evidence isn't currently available to support self-tests replacing smear tests administered by trained healthcare professionals, and are particularly cautious of private offerings.

Professor Kamila Hawthorne, chair of the Royal College of GPs, told Which?: 'We would not advise women to use commercial self-testing kits as a replacement for cervical screening provided by the NHS.

'Paid-for tests don't always come with all the information you need, and if you do use them, you might not be able to get follow-up care through the NHS' (without starting over and getting an NHS cervical screening test). 

Cancer Research UK's Dr Rachel Orritt says that research is ongoing to determine if self-testing for cervical screening is accurate before it is considered as part of the national programme, and added: 'We don't encourage people to be screened for cancer outside the NHS national screening programme.'

However, given the link between high-risk HPV and cervical cell changes that may lead to cancer, some experts say self-testing for HPV has a role to play in helping women take proactive steps for their health, especially where lack of time, cultural barriers or embarrassment may get in the way.

Royal Pharmaceutical Society president Professor Claire Anderson says: 'These tests have become a key tool in increasing access to cervical cancer screening. While this option won’t replace the valuable interaction with a healthcare professional, it provides a less invasive alternative and research shows 99% of people are able to do it accurately at home.'

Are home health test kits worth it? They promise to give you answers but they might just leave you out of pocket instead

Tips for a more comfortable cervical screening experience

For now, it's worth knowing what you can do to make an in-person test more comfortable. Here are some tips:

• Be prepared. Before you attend your cervical screening, read up about the process so you know what to expect. A good start is this NHS video guide to cervical screening.
• Explain how you are feeling upfront. You can ask specifically for a female health provider if it makes you feel more comfortable, and tell whoever is doing your test if you are feeling anxious or have had issues with pain previously. There are a number of things they can do to help.
• Ask for a different sized speculum. This instrument is put inside your vagina to open it up for easier access to the cervix. If it's uncomfortable ask your health provider to use a smaller size, more lubricant or try a different position. They should work with you to make it comfortable, but if you are in pain you can stop at any time.
• Wear clothes you feel comfortable in. And by this we mean ones that help you to cover up so that you only have to take off your underwear during the screening test – a dress or skirt may be better than trousers or a jumpsuit. You will also be given a sheet to cover up.
• Ask to attend a specialist clinic. Cervical screening can be done at your GP surgery, but there are other options if this doesn't work for you. Your GP can refer you to your local hospital gynaecology clinic, which may have a wider range of speculum sizes, for example.

Private GPs – we compare costs, add-ons and the pros and cons of choosing a private appointment

Self-testing HPV kits: what's available now?

If you are considering using an HPV self-test kit, here are some commercial kits that are currently available. Please note we have not tested these products and these are not recommendations.  

Any test you do buy should give clear guidance on what your results mean and next steps. Bear in mind if you get a positive result it's likely you will need to go to your NHS GP and book in for a smear test.

The Doctors Laboratory HPV home test kit (from £55)

Available from Asda, Superdrug Online Doctor

Test type: Vaginal swab to post to laboratory

How it works: You use a cotton bud-like collection swab to take a specimen of vaginal cells to send to the laboratory in a prepaid envelope. Results will be available within seven days of the sample reaching the lab.

What to know: Information on the Superdrug site says this HPV test is different to that used by the NHS and 'you may need further testing by the NHS' if issues are found.

It also cautions: 'The HPV test does not replace the need for regular smear tests.'

Daye HPV Screen (£69)

Available from Daye

Test type: Tampon

How it works: This 'non-invasive at-home tampon screening kit' screens for HPV16, HPV 18 and 12 other high-risk HPV strains.

The Daye 'Diagnostic Tampon' – complete with applicator – is worn in the vagina for 20 minutes before being removed and sent to Daye for analysis.

Results come back within five to 10 days with a detailed report. If you test positive for an STI you'll get a free consultation with a sexual health nurse.