Benefit of cervical screening at different ages: evidence from the UK audit of screening histories

While most experts agree that cervical screening is effective, there remains controversy over the most appropriate screening interval. Annual screening is common in North America. In England, some argue for 3-yearly screening while others believe 5-yearly screening is adequate, and the frequency var...

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Bibliographic Details
Published in:British journal of cancer 2003-07, Vol.89 (1), p.88-93
Main Authors: Sasieni, P, Adams, J, Cuzick, J
Format: Article
Language:English
Subjects:
Adult
Age
Age Factors
Aged
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Cancer Research
Case-Control Studies
Cellular biology
Cervical cancer
Databases, Factual
Drug Resistance
Epidemiology
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Health Policy
Humans
Laboratories
Mass Screening
Medical Audit
Medical History Taking
Medical research
Medical sciences
Medical screening
Middle Aged
Molecular Medicine
Neoplasm Invasiveness
Oncology
Practice Guidelines as Topic
Tumors
United Kingdom
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - pathology
Vaginal Smears
Womens health
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Summary:While most experts agree that cervical screening is effective, there remains controversy over the most appropriate screening interval. Annual screening is common in North America. In England, some argue for 3-yearly screening while others believe 5-yearly screening is adequate, and the frequency varies from one part of the country to another. Screening histories of 1305 women aged 20–69 years, diagnosed with frankly invasive cervical cancer and 2532 age-matched controls were obtained from UK screening programme databases. Data were analysed in terms of time since last negative, and time since last screening smear. Five-yearly screening offers considerable protection (83%) against cancer at ages 55–69 years and even annual screening offers only modest additional protection (87%). Three-yearly screening offers additional protection (84%) over 5-yearly screening (73%) for cancers at ages 40–54 years, but is almost as good as annual screening (88%). In women aged 20–39 years, even annual screening is not as effective (76%) as 3-yearly screening in older women, and 3 years after screening cancer rates return to those in unscreened women. This calls into question the policy of having a uniform screening interval from age 20 to 64 years and stresses the value of screening in middle-aged women.
ISSN:0007-0920
1532-1827
DOI:10.1038/sj.bjc.6600974