DIY smear tests for women in England may be imminent, after a pilot scheme produced promising results. In London, 27,000 undertested or untested women were offered a DIY kit by their GP or were sent one by post; 56% of the first group did the test and 13% of the second, presumably picking up women who would otherwise not have been tested for all sorts of reasons, from trauma to lack of time. The researchers from King’s College London estimate that, if this was replicated throughout England, more than 1 million more people could be tested over a three-year cycle. That’s brilliant – rightly heralded a “gamechanger”.
I thought all the cervix-owners of my acquaintance would be overjoyed at this news, but there were a surprising number of reservations. One friend interrogated the practicalities: “How could you take a sample cleanly from the right place, jabbing blindly in the undergrowth? Maybe it’s a two-person job and you have to direct your significant other: ‘Fold flap A into slot B, Richard. No, not like that.’”
“Everyone is going to do it wrong,” said another, darkly. Reading the test instructions, it sounds a bit like a vaginal lateral flow test; admittedly, I was very bad at the Covid version of those.
But the most pressing question of all was: if you don’t need a professional with a speculum to take a smear, why on earth are we still doing it that way? Other countries have already introduced self-testing, including Australia, the Netherlands, Denmark and Sweden.
While they are vital, no one would mistake a smear test for a spa day. It is an awkward, occasionally excruciating dance of wondering where to put your underwear, draping yourself in a pointless fig leaf of scratchy paper, “flopping” your knees, “wriggling down” and developing a complex about your cervix after casual comments about it being “weird” or “at a funny angle”. At my worst, in Belgium, a fag-scented gynaecologist inserted the speculum and then seemingly lost his train of thought, wandering off for 10 minutes to have a beer or eat a waffle or something. Yup, even if the instructions are more gnomic than Ikea’s, I’ll be team DIY.