Cervical cancer screening in older womenBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n280 (Published 05 February 2021) Cite this as: BMJ 2021;372:n280
- Clare Gilham, assistant professor1,
- Emma J Crosbie, professor of gynaecological oncology23,
- Julian Peto, professor of epidemiology1
- 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- 2Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- 3Gynaecology Department, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Correspondence to: C Gilham
Most women in the UK aged over 65 years have never had a test for human papillomavirus (HPV). On present trends, about 5000 of these 6.5 million women will die from cervical cancer over the next 35 years.
The NHS cervical screening programme has been among the most successful in the world, preventing an estimated 5000 deaths a year1 by offering regular cytology up to age 65. HPV testing of cervical samples has now replaced cytology for primary screening in many countries, including the UK. In Australia this was accompanied by an increase in the upper age for screening to 74,2 and in Denmark all women born before 1948 have been offered an HPV test.3 But in England, where half of all cervical cancer deaths are now among women aged 65 years or over, screening is still stopped at age65.
The NHS programme justifies not screening women beyond age 64 because “it is highly unlikely that women over 64 who have been …