Safety of extending screening intervals beyond five years in cervical screening programmes with testing for high risk human papillomavirus: 14 year follow-up of population based randomised cohort in the NetherlandsBMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i4924 (Published 04 October 2016) Cite this as: BMJ 2016;355:i4924
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Cervical cancer has an alarming survival rate of 68% with a 10-year survival rate of 64%. It is estimated that 4,120 deaths from the disease will occur this year, but it can be been reduced significantly through vaccination and early screening (1).
The selected population is women aged 29-61 years old, which means that for persons below this age group, early screening is not necessary as the natural history of HPV infection shows that it is transient in young women, with most cases regressing within 2 years of presentation. In addition, because serious cytological abnormalities and cancer are rare in this group (2), young women should not see this as a safety net especially when having sex with multiple partners. They must be mindful that when they reach the age for screening, they may have already increased their risk of contracting HPV. Though insufficient data are known about the epidemiology of human papillomavirus (HPV) in young women before the age of 25, and given the low positivity in this population, smokers and sex with multiple partners make them susceptible (3).
I strongly believe that health promotion and prevention is the best way to reduce the risk of contracting the human papilloma virus. Young women need to be educated on practicing safe sex, thus reducing the possibility of being diagnosed with cervical cancer later in life.
Cancer.Net (2016). Cervical Cancer: Statistic. Retrieved from http://www.cancer.net/cancer-types/cervical-cancer/statistics
Henrique, Q., Campaner, B& Salomão, A (2016). Cervical Cancer Screening of Adolescents Should Not Be Encouraged. Journal of Lower Genital Tract Disease, doi: 10.1097/LGT.0000000000000273
Igidbashian, S., Boveri, S., Bottari, F., Vidal, A., Preti, E., Casadio, C., Landoni, F., Sideri, M., & Sandri(2016). Prevalence and Risk Factors of Human Papillomavirus Infection in 18-Year-Old Women: Baseline Report of a Prospective Study on Human Papillomavirus Vaccine. Journal of Lower Genital Tract Disease, doi: 10.1097/LGT.0000000000000268
Competing interests: No competing interests
In a recent analysis of all available studies, cancer screening has never been shown to “save lives”. 
The cumulative incidence of women with cervical cancer was only 0.09% after 15 years, in this study.
Thoughts for extending screening period from 5 to about 10 years are expressed.
This means that low risk women over 40 will be screened 3-4 times in their lifetime.
Younger generations of women will be rendered low risk through ongoing HPV vaccination programs.
Even if invasive cervical cancer is present and colposcopically visible, stage IA1, affected women can expect survival rates of 99%. 
Even delayed treatment for diagnosed cervical cancers, at Stage I, was not associated with worse survival. 
Anyhow, we should not rush to praise cytology based cervical screening, implying that Pap test demonstrates cardinal significance in detecting early precancerous lesions and minimal cervical cancers.
This is not the case, after studying recent sensitivity and specificity evidence, compared to VIA colposcopy. 
This 2 minute technique during routine clinical examination, is very cheap, does not require an attached Cytology Laboratory, uses naked eye or simple magnifying lense inspection, can even be performed by briefly trained nurses, effectively detects the same amount of CIN II/III lesions, and can be combined with immediate point of care treatment options.
If a nurse in rural India, in a low resource setting, manages to detect the same precancerous cervical lesions compared to trained Consultant Gynecologists, Specialist Colposcopists, Histopathologists, Cytologists, Consultant Oncologists, midwives, all part of a Western National screening program, then everybody realizes that the attributed value of such a screening program is questionable.
Statistically, sexually active women will experience vaginal ailments that necessitate clinical colposcopic examination sooner than 5-10 years, so any potential cervical lesions would be detected before formal screening periods.
Competing interests: I would lose patient visits and money if cervical screening periods were extended to ten years or abolished, yet I strongly support such changes since they are for the benefit of women and National Healthcare Systems.
Once diagnosed HPV negative (in cervical screening programmes with testing for high risk human papillomavirus), women should be given HPV vaccination
What Does My HPV Test Result Mean? (http://www.cdc.gov/cancer/cervical/pdf/hpv_testing_2012_english.pdf):
HPV test will come back as either “positive” or “negative.”
■ A negative HPV test means you do not have an HPV type that is linked
to cervical cancer.
■ A positive HPV test means you do have an HPV type that may be linked
to cervical cancer. This does not mean you have cervical cancer now. But it
could be a warning.
Our contention is that if diagnosed HPV negative (in cervical screening programmes with testing for high risk human papillomavirus), these subjects should be given HPV vaccination immediately in order to protect them from carcinogenic strain as there will be no interference with developing immunogenicity of the vaccine. We should not miss the opportunity of immunization in HPV negative subjects.
Competing interests: No competing interests