Young women at threat of cervical cancer


smear test Thousands of young women could be at risk of life-theatening cervical cancer after being excluded from the NHS screening programme, say doctors.

Regular smear tests are no longer offered to women under 25 and experts say at least 3,000 women will develop abnormalities that could result in cancer if left untreated.

A change of policy in 2004 stopped women aged 20 to 24 years from getting screening tests on the grounds it could do 'more harm than good'.

But specialists fear the policy has delayed detection of abnormalities in younger women and deterred women in their late 20s from having smears.

At the same time, women may wrongly think two new vaccines against cervical cancer will protect them.

Figures out last month revealed a massive drop in smears in the 25-29 age range, with a 10 per cent fall over the last 10 years.

Consultant cytopathologists Amanda Herbert, from Guy's and St Thomas' NHS Foundation Trust in London, and John Smith, from the Royal Hallamshire Hospital in Sheffield, say the new policy is putting women at risk.

In a letter to the British Medical Journal (BMJ), they said women now started having sex at a younger age and may therefore experience serious cell changes when they are between 20 and 24.

Smear tests pick up changes in the cells of the cervix, with the most serious, CIN3, being a precursor to cancer.

However, the delay in offering smears to younger women means at least 3,000 will have untreated serious abnormalities by the time they are included in the national screening programme.

Dr Herbert said these cell changes might revert back to normal without treatment and full-blown cancer is rare in under-25s.

But the wrong message was being sent to young women, she said.

"If you don't invite them as part of an organised programme you risk putting them off.

"They have been told it could do more harm than good which is not going to encourage them to attend for smears when they do get invited.

"An epidemic of cervical cancer has been prevented by screening women when they were young and we don't want to see the national programme undermined" she added.

The NHS screening programme says women under 25 don't need to be included because full-blown cancer is rare in that age group and they might get unnecessary treatment for abnormalities that would regress in time.

But Dr Herbert said invasive cancer can develop within a couple of years if there are missed opportunities to investigate and treat, usually with an outpatient surgical procedure.

Of particular concern, is the drop in attendance for smears among women in their late 20s who are at greatest risk of CIN3.

She said women may also have been lulled into a false sense of security by new vaccines against the disease.

"However, it is clear women will need to have regular smear tests for some time to back up the vaccines" she said.

Richard Winder, deputy director of the NHS Cancer Screening Programmes, said "The NHS Cervical Screening Programme is internationally recognised as one of the best in the world, saving 4,500 lives a year.

"The programme's policy to screen women from the age of 25 is based on robust, independent research by scientists at Cancer Research UK.

"This policy is supported and endorsed by the World Health Organisation's International Agency for Research on Cancer.

"The programme is always alert to new evidence and information when it becomes available and seriously considers any studies which could further improve the service."

In 2002, five women aged between 15 and 24 in England died from cervical cancer, and 26 cases were registered, according to the programme.

source Daily Mail UK 


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