How to Reduce Carbon Emissions From Cervical Screening?
In the UK, over 3,000 women are diagnosed with cervical cancer each year, primarily caused by persistent infection with human papillomavirus (HPV). During a routine screening appointment, a healthcare professional inserts a speculum into the vagina to view the cervix and uses a soft brush to collect cervical cells, which are then tested for HPV.
An alternative screening method allows women to collect their own sample at home using a vaginal swab (self-sampling), a practice available in 17 countries but not yet in the UK. Another potential method involves collecting a urine sample at home, which is currently being evaluated in the UK. Research indicates that urine sampling is widely accepted and may encourage participation in cervical screening, especially among women less likely to attend, including those from minoritized groups.
Clinic-based screening has environmental impacts related to patient travel and the use of clinic resources, such as gas and electricity. The NHS aims to achieve net-zero carbon emissions by 2045. Self-sampling could contribute to this goal by reducing emissions.
This study compared the carbon emissions of different cervical screening methods
The researchers compared carbon emissions from three cervical screening methods: samples collected by a healthcare professional versus vaginal and urine self-samples. They considered all steps in each approach, from invitation to lab sample preparation, collecting their own data and using external sources (such as manufacturer materials).
The findings showed that routine screening at a healthcare facility produces:
- 8.7 times more carbon dioxide (3,670g) than vaginal self-sampling (423g)
- 6.4 times more carbon dioxide than urine self-sampling (570g)
For routine cervical screening, the majority of emissions came from running the appointment at the healthcare facility (2,758g). The differences between the self-sampling methods were minimal.
Why is this important?
NHS carbon emissions contribute 4% of the UK’s carbon footprint, and self-sampling could help reduce this. Researchers estimate that nationwide adoption of self-sampling could cut carbon emissions by 4,076 tonnes. They hope their findings will encourage further research on measuring the environmental impact of healthcare pathways and treatments.
Currently, only 69% of eligible individuals participate in cervical screening, and participation rates are declining. Barriers include difficulty accessing appointments, as well as the embarrassment, discomfort, or pain associated with the speculum examination. Self-sampling could alleviate these concerns and increase participation rates, alongside its environmental benefits. Research suggests that at least half of women would opt for self-sampling if offered.
However, researchers note that even if in-person screening appointments are reduced, healthcare providers are likely to fill those slots with other patients, meaning that emissions from travel, heating, and other factors will continue. As more appointments become virtual or are adapted to lower their carbon footprint, overall emissions may gradually decrease.
The study also acknowledged several assumptions about self-sampling logistics and could not account for all variables, such as the impact of unreturned sample kits.
If self-sampling is introduced in the UK, individuals will need information about the pros and cons of each method
If self-sampling is introduced in the UK, individuals will need information about the pros and cons of each method, including environmental impacts, to make informed decisions about their screening options.
This study is part of a broader project exploring urine self-sampling for cervical screening, including aspects like test accuracy, acceptability, and cost-effectiveness. Further research is needed to evaluate the real-world implementation of self-sampling for cervical screening.
