Observations Medicine and the Media

GMTV’s Dr Steele is wrong to promote cervical screening in under 25s

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6167 (Published 28 September 2011) Cite this as: BMJ 2011;343:d6167
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}margaretmccartney.com

Should young women have cervical smear tests below the age of 25? The evidence says it is harmful, so why are some general practitioners requesting it anyway, asks Margaret McCartney

“Women used to be routinely screened from the age of 20. But in 2003 the government raised the age to 25 in England because it said early testing might actually do more harm than good. But we’ve been approached by GPs who say what this actually means is tests that they’re carrying out on women under 25 that they think are necessary are being rejected and in some cases are even being destroyed by the labs just because they fall outside of the screening guidelines.” So began an item on BBC television’s Newsnight programme.

The programme asked English laboratories what they did with cervical smear tests from women aged under 25 years old. It found that more than 700 tests last year had not been read because the women were outside the guideline age. There was substantial variation between laboratories, and the journalist Anna Adams concluded that some laboratories thought that it was “the right thing” to read the smears but that others didn’t. She said, “What that means is hundreds of young women are going in for these invasive tests that aren’t even going to be looked at . . . GPs say they’re the ones that know which patients should and shouldn’t be screened, and they’re angry their clinical acumen could be …

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