A new urine test for cervical cancer could be 'game-changing' for the more than 40,000 women in Nottinghamshire who missed their last smear test.
Researchers from the University of Manchester have found that urine samples could be as effective at detecting the cancer-causing HPV virus as current cervical screening tests.
Charities say advancements towards a less intrusive examination could be an important move to address the embarrassment and fear that often holds women back from getting tested.
In Nottinghamshire, the uptake rate for cervical screenings has fallen for each of the last six years.
Only 77.9 per cent of the 207,700 women who were due a smear test before the end of March 2018 attended an appointment, according to the latest figures from NHS Digital.
This means around 45,870 women missed out on the 'life-saving' programme.
Women aged between 25 and 49 are invited for a screening every three years, while those aged 50 to 64 attend every five years.
Currently, cervical screening requires a test that looks for changes in the cells of the cervix which could develop into cancer.
A small sample of cells is taken from the cervix using a soft brush.
Across England, attendance has also fallen for the fourth consecutive year, to 71.4 per cent in 2017-18.
More than 100 women who attended a clinic after abnormal cells were found on their cervix were asked to take part in the latest research, according to the study published in the British Medical Journal.
The results found a urine test was just as good at detecting the HPV virus as cervical smears or vaginal swabs.
Athena Lamnisos, chief executive of women's health charity The Eve Appeal, said: "For women living with the impact of female genital mutilation, who have suffered sexual abuse, or live with conditions such as vaginismus, screening in a non-invasive way could be game-changing for screening uptake.
"This research sounds like a promising early step, but is some way off being rolled out through the NHS.
"In the meantime, women must continue to book their screening appointment when they’re called."
Cervical cancer charity Jo's Trust said more research was needed to better assess the accuracy of urine tests.
Robert Music, chief executive, said: “With cervical screening attendance at an all-time low, advancements in the programme which could change this are essential.
"HPV self-sampling is another advancement with the potential to increase screening attendance and is something we want to see introduced as soon as possible.”
More than 3,000 women are diagnosed with cervical cancer every year in the UK.