Cervical screens still needed for under-25s

Ruling women under 25 out of cervical screening could increase the number of cervical cancers diagnosed at later ages, a gynaecological oncologist has said.

Speaking at the Primary Care 2007 conference in Birmingham, Dr Amanda Tristram, from the University of Wales College of Medicine, said the decision to screen women in England for cervical cancer from the age of 25 rather than 20 was ‘a huge error’.

Since 2003, the National Cervical Cancer Screening Committee has ruled that smear tests should be taken every three years from the age of 25 to 49 and every five years from 50 to 64.

They excluded younger women because invasive cervical cancer is rare in women under 25.

Additionally, younger women may have abnormalities when nothing is wrong, leading to unnecessary investigations and treatment that may do more harm than good.

Screening in Northern Ireland is also for over-25s. But in Wales and Scotland, women are called for smear tests from the age of 20.

Dr Tristram said this is important because the risk of pre-cancerous abnormalities is still high in those aged 20 to 25.

‘I suspect we will start to see more cervical cancers in women aged 25 to 29 when they turn up for their first smear,’ she said.

Bradford GP Dr Anne Connelly said the changes to the screening programme were intended to reduce unnecessary costs and anxiety.

However, given the emergence of endocervical cancer, which primarily affects younger women, another change may be needed, she said: ‘It’s likely they will have to change the age and lower it again.’

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