A cohort effect in cervical screening coverage?

The objective of this study is to analyse cervical screening coverage data over time.

Routinely collected cervical screening statistics, in England, on the proportion of women who have undergone cervical screening with cytology during the preceding five years. The participants included all women residents eligible for cervical screening.

Overall coverage remained at about 82% or over between 1995 and 2000. Since 2000, however, coverage has drifted slowly down to just over 80% in 2005. Coverage has long been observed to be related to age. In 2005, the coverage rate was 71% in women aged 25-29, 83% in those aged 35-54 and 75% in those aged 55-64. Comparing coverage by age in the three years--1995, 2000 and 2005--shows broad conformity with this pattern in each of the three years, but overlaid is the fact that at ages below 50, the rate has been falling while at ages above 55, the rate has been rising. The fall in screening coverage appears to be largely a cohort effect, with women born in the 1960s and later being increasingly less likely to participate.

No specific reason for this effect is evident. Action could be targeted at women aged 25-34 to address falling coverage.