PINCS 1 study shows strong support for earlier postnatal cervical screening

A research study led by our trust has shown strong support for offering cervical screening earlier in the postnatal period.

It’s a finding that could improve uptake, convenience and early detection for thousands of people after giving birth.

The PINCS‑1 study explored whether cervical screening could safely and acceptably be carried out at the routine six‑week postnatal check, rather than the traditional 12‑week appointment.

The study also tested whether urine samples could be used as an alternative method for screening.

Dr Victoria Cullimore, our clinical research fellow, has been closely involved in running the study.

She says the early findings are “encouraging, practical and full of potential for real‑world change”.

“We know that attending appointments shortly after having a baby can be extremely difficult,” she explains.

“If we can align cervical screening with the six‑to‑eight‑week check, an appointment people are already planning to attend, we remove a significant barrier.”

Participants were invited to take part from three hospitals across the south west, with almost half of those invited (47%) agreeing to join the study.

Everyone who took part had both the usual cervical screening test and a urine test at six and 12 weeks after giving birth, and completed a short questionnaire about their experience.

Victoria says the high level of interest and participation reflects a wider appetite for more accessible screening.

“People want to attend screening, but the challenge is fitting it into busy, demanding lives,” she says.

“What we’re hearing is that timing really matters, and six weeks feels more convenient and more achievable for many new parents.”

The study found that, overall, participants did not experience more discomfort at six weeks compared with 12, and 95% said they would be happy for their future cervical screening to be carried out at six weeks after birth.

“That level of acceptability is incredibly important,” Victoria adds. “It suggests that changing the timing could improve uptake without compromising comfort or safety.”

“The clinical results were also reassuring as we saw excellent agreement between the six‑week and 12‑week HPV test results. In 95% of cases, the results were identical, which gives us confidence that earlier screening is reliable.”

Although urine testing did not detect as many HPV cases as the usual clinician‑taken sample, it did identify the one participant who had abnormal cells on their cervical screening.

Victoria says this highlights an important avenue for future research: She adds: “Urine testing is simple, private and non‑invasive, and even though it’s not perfect yet, it absolutely has potential, especially for people who avoid screening because of discomfort or anxiety.”

The findings suggest that a larger study, the next step in the PINCS programme, is both feasible and worthwhile.

The team recently started the next study phase (PINCS-2) where participants will receive cervical screening at either six or 12 weeks using three different approaches: the usual cervical swab, a urine test and a vaginal self‑swab.

Victoria says involving people with lived experience is an essential part of designing the next stage.

“We want this research to reflect real people’s lives, real barriers and real preferences,” she says. “That’s why we’re running discussion groups, so the public can help shape what comes next.

“In the longer term, we hope the work will contribute to the evidence base needed to change national, and potentially international, postnatal screening guidelines.

“Postnatal care is a window of opportunity, and if we can make cervical screening easier, earlier and more flexible, we have the chance to protect more people from cervical cancer.”

For more information or to get involved in upcoming groups, contact the research team at PINCSstudy@somersetft.nhs.uk.