Re: Cervical cancer is not just a young woman’s disease
Thank you for taking the time to comment on our article. We are not claiming that cervical cancer is not a young woman’s problem rather that it is not exclusively a young woman’s problem and the title reflects this.
We do not argue simply for an increase in the upper screening age. We suggest that it should be reviewed and kept under review as the population continues to age. Increasing the upper screening limit is one of several options we would like to see considered. One of these is to encourage those women currently eligible to attend cervical screening when invited.
Having said that, we do believe that the HPV test currently being piloted for primary screening brings along with it the potential for increasing the upper screening age limit effectively. This test introduces the potential for home self-sampling or less physically challenging sampling in the primary care setting which would make screening a more viable option for those older women who might experience considerable discomfort during the procedure.
As we report in the article, Elit’s (2014) literature review exploring cervical screening in older women reported that screening is beneficial until at least age 69 in terms of preventing occurrence of and death from cervical cancer. With the exception of the Castanon et al (2014) study the other studies reviewed found that the protective effect of screening in older women was up to around five years. This would make increasing the upper age limit imperative in a population of women who can expect to live on average nearly 19 years after the screening programme in the UK ends.
Importantly we are proposing that two approaches to cervical screening in older women are needed. The first is to increase the uptake of screening amongst women currently eligible. The other is to explore and keep under review options for increasing the upper age limit for screening. Further research is urgently needed to facilitate both approaches.
Competing interests:
No competing interests
09 July 2015
Susan M Sherman
Senior Lecturer in Psychology
Alejandra Castanon, Esther Moss, and Charles W. E. Redman
Rapid Response:
Re: Cervical cancer is not just a young woman’s disease
Thank you for taking the time to comment on our article. We are not claiming that cervical cancer is not a young woman’s problem rather that it is not exclusively a young woman’s problem and the title reflects this.
We do not argue simply for an increase in the upper screening age. We suggest that it should be reviewed and kept under review as the population continues to age. Increasing the upper screening limit is one of several options we would like to see considered. One of these is to encourage those women currently eligible to attend cervical screening when invited.
Having said that, we do believe that the HPV test currently being piloted for primary screening brings along with it the potential for increasing the upper screening age limit effectively. This test introduces the potential for home self-sampling or less physically challenging sampling in the primary care setting which would make screening a more viable option for those older women who might experience considerable discomfort during the procedure.
As we report in the article, Elit’s (2014) literature review exploring cervical screening in older women reported that screening is beneficial until at least age 69 in terms of preventing occurrence of and death from cervical cancer. With the exception of the Castanon et al (2014) study the other studies reviewed found that the protective effect of screening in older women was up to around five years. This would make increasing the upper age limit imperative in a population of women who can expect to live on average nearly 19 years after the screening programme in the UK ends.
Importantly we are proposing that two approaches to cervical screening in older women are needed. The first is to increase the uptake of screening amongst women currently eligible. The other is to explore and keep under review options for increasing the upper age limit for screening. Further research is urgently needed to facilitate both approaches.
Competing interests: No competing interests