Cervical screening

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7451.1272 (Published 27 May 2004) Cite this as: BMJ 2004;328:1272
  1. Angela E Raffle, consultant in public health (angela.raffle@bristolnorth-pct.nhs.uk)
  1. Bristol North Primary Care Trust, Bristol BS2 8EE

    Recent changes in policy regarding age and frequency are a poor use of resources

    Two expensive healthcare practices have recently been endorsed as policy in England and Wales.1 One is continuing to invite women over 50 for cervical screening; the other is shortening the screening interval from five years to three for younger women. National decisions on single issues disregard competing needs and force local decision makers to neglect other, more pressing, problems.

    To inform its decision the NHS cervical screening programme commissioned a case-control analysis.2 The difference between three yearly and five yearly screening is too small to measure, which is why we are having to use estimates, despite a huge natural experiment involving widely differing screening intervals throughout the nation and worldwide. The analysis estimated that, for women under 40, the risk reduction is 30% with five yearly screening and 41% with three yearly screening.2 For women aged 40-54 years it is 63% and 69% respectively. The paper …

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