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Shorter interval between cervical screens will reduce incidence of cervical cancer

BMJ 2004; 329 doi: (Published 05 August 2004) Cite this as: BMJ 2004;329:310
  1. Roger Dobson
  1. Abergavenny

    Reducing the interval between cervical screens from five to three years will substantially reduce the incidence of cancer of the cervix, new research has shown.

    In 2003, the NHS cervical screening programme announced that the screening interval would be reduced to three years in women aged 25-49 and fixed at five years in those aged 50-64, and that women aged under 25 years would no longer be invited for screening.

    The new research, based on a mathematical model, found that lowering the screening interval in women aged 25-49 is likely to mean an 18% reduction of the cumulative lifetime incidence of cervical cancer compared with screening practice before 2003 (British Journal of Cancer 2004;91:530-6).

    The report, by three researchers from the Cancer Research UK Epidemiology Unit in Oxford and Julietta Patnick, director of the NHS cancer screening programmes, says that the predicted lifetime incidence of invasive cervical cancer in the UK is 1.70% in the absence of screening and 0.77% with pre-2003 screening practices. A reduction in lifetime incidence to 0.63% is predicted with the programmes' 2003 recommendations.

    “The study supports the 2003 recommendations for changes to cervical screening intervals,” says the report, which adds that screening women aged 20-25 years would have minimal impact.

    In the same journal, a review by Sue Moss from the Institute of Cancer Research Cancer Screening, Sutton, discusses whether more frequent screening should be introduced for breast cancer. It shows that, although the incidence of breast cancer is lower at younger ages, the life years lost due to cancers diagnosed at below age 50 amount to a third of all those lost due to the disease (British Journal of Cancer 2004;91:413-7).

    But the review says that more information is needed on the effects of screening women under 50 before decisions can be made: “Until more information is available, it is difficult to inform either policymakers or individual women on the balance between costs and effectiveness of screening below 50 years. It has recently been suggested, on the basis of age-specific incidence rates, that screening in the UK should begin at 47 years, but the effect of such a policy in terms of mortality reduction is not clear,” it says.

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