Cervical screening in 20-24-year olds

Area of Science:

• Gynecologic Oncology
• Public Health
• Preventive Medicine

Background:

• England's NHS Cervical Screening Programme shifted the minimum screening age from 20 to 25 in 2003.
• This review assesses the evidence for and against cervical screening in 20-24 year old women in Wales.

Purpose of the Study:

• To evaluate the benefits and harms of cervical screening for women aged 20-24 in Wales.
• To analyze the impact of the Welsh organized call/recall screening program on cervical cancer rates.

Main Methods:

• Conducted a literature review on cervical screening effectiveness and harms.
• Analyzed Welsh data on high-grade cervical intraepithelial neoplasia (CIN3) and invasive cervical cancer rates (1981-2003).
• Reviewed medical records of women under 25 diagnosed with cervical cancer and performed a cost analysis.

Main Results:

• No randomized controlled trials were found for screening young women, but organized programs reduce cervical carcinoma incidence.
• Cervical cancer reduced by 58% in Welsh women aged 20-24 and 45% in women aged 25-29 post-1988 screening program.
• Preventing one cervical cancer in the 20-24 age group is estimated to cost at least £82,500.

Conclusions:

• The incidence of cervical cancer in young women has halved since the Welsh screening program's inception.
• Recommend continuing cervical screening invitations for Welsh women starting at age 20.
• Further data is needed to compare cervical cancer incidence and diagnostic stage across the UK based on varying first screening ages.