Cervical cancer screening shouldn’t start until 25

By Kirsten McCaffery, University of Sydney; Alexandra Barratt, University of Sydney, and Jane Williams, University of Sydney

Women in England, Scotland, Wales and Northern Ireland will all soon be advised to start screening for cervical cancer at 25 years, and those aged between 50 and 64 years to screen every five years rather than every three. And a review of the Australian National Cervical Screening Program is considering whether it should make the same recommendations.

The Australian review is considering evidence on the screening starting age and the interval between Pap smears, as well as different screening technologies such as Liquid Based Cytology (LBC) and primary HPV testing. It coincides the with major changes in similar programs in the United Kingdom based on recommendations by the UK National Screening Committee (NSC).

The policy change was made in England in 2003 and Northern Ireland in 2010. And following a recent review, the protocol has been recommended for extension to both Scotland and Wales.

The changes are based on evidence that screening women under 25 offers little benefit. In fact, screening this age group arguably causes “more harm than good” with little or no health benefit, and potential physical, psychological, and economic harms. Cervical cancer is extremely rare in young women and the efficacy of screening drops as age decreases.

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