Modelling is useful in evaluating early withdrawal of women from smear test programmes

In the United Kingdom postmenopausal women who are at little risk of developing cervical cancer remain in the screening programme until the age of 64. It has been suggested that these women could be removed from the programme earlier with little impact on the incidence of invasive cancer. Sherlaw-Johnson et al (p 356) used a mathematical model to evaluate the effectiveness of early withdrawal both with and without the addition of testing for human papillomavirus infection. Their analysis suggests that early withdrawal policies would lead to a substantial reduction in the resources devoted to screening. Such policies are, however, likely to increase the overall incidence of cervical cancer unless other steps are taken to compensate.


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Relevant Article

Withdrawing low risk women from cervical screening programmes: mathematical modelling study • Commentary: trials versus models in appraising screening programmes

C Sherlaw-Johnson, S Gallivan, D Jenkins, and Geoff Royston
BMJ 1999 318: 356-361. [Abstract] [Full Text] [PDF]