Older Women 'Still Need Screening for Cervical Cancer'

Guardian.co.uk

April 24, 2009

United Kingdom

Older women who think they no longer need a smear test for cervical cancer should think again, according to a big new study. It found that women aged over 50 have about the same risk of getting the cancer as younger women, and should continue to have regular screening.

What do we know already?

Cervical cancer screening works by detecting cell abnormalities (called lesions) that may or may not turn cancerous in future. It means women can have treatment for these lesions, in the hope they won't turn into cancer. 

In the UK, women are currently offered cervical cancer screening (smear tests) between the ages of 25 and 65. But some doctors-and women-think it's a waste of time screening women over 50, because tests are far less likely to show lesions in older women. However, we also know that lesions which do appear in women over 50 seem more likely to develop into cancer, if they're not treated.

It's been proposed by some specialists that women over 50 who've had three clear screening tests running could be dropped from the screening programme. This study was done to see whether stopping screening of women at age 50 would make sense, or whether it would lead to an increase in untreated cervical cancers. Researchers followed 664,229 women who'd had three consecutive clear smear tests for 10 years. Of these, 445,382 were between the ages of 30 and 44, and 218,847 were between 45 and 54.

What does the new study say?

The women aged 45 to 54 were just as likely as the women aged 30 to 44 to develop cervical cancer, over a 10-year period. As expected, they had about half as many lesions detected during screening. But their chances of having cervical cancer were similar. 

For every 100,000 women aged 30 to 44 who were followed for 10 years, 41 got cervical cancer. For every 100,000 women aged 45 to 54 who were followed, 36 got cancer. Researchers say the slight difference in numbers is too small to be significant. 

How reliable are the findings?

These findings should be quite reliable. The study was very large and used good-quality, reliable data from laboratories. 

Where does the study come from?

The study was carried out by researchers from the Department of Public Health in the Netherlands, and the University of Copenhagen in Denmark, using data from cancer registries and pathology laboratories in the Netherlands. It was published in the British Medical Journal (BMJ) which is owned by the British Medical Association. It was paid for by the Dutch National Institute for Public Health and the Environment. 

What does this mean for me?

If you're tempted to stop having smear tests just because you're getting older, this study suggests you should think again. Your risk of cervical cancer is about the same at 50 as it is at 30, even after three clear tests. The study suggests that the UK's current policy of screening women up to age 65 makes sense. 

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