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Published on: June 14, 2019
Increased cervical cancer risk associated with screening at longer intervals
Walter Kinney1, Thomas C Wright, Helen E Dinkelspiel
1Department of Women's Health, the Permanente Medical Group, Sacramento, California; the Department of Pathology (emeritus) and the Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons, New York, New York; the University of Connecticut, Farmington, Connecticut; the University of California (retired), Santa Barbara, California; and the University of Alabama, Birmingham, Birmingham, Alabama.
Abstract:
The 2012 national recommendations for cervical cancer screening will produce a lower level of cervical cancer protection than previously afforded by annual cytology or 3-year cotesting. After a single negative cotest result, the risk of cervical cancer is twice as large at 5 years as it is at 3 years. Modeling published since the 2012 guidelines were drafted indicates that extending the cotesting screening interval from 3 to 5 years at ages 30-64 years will result in an additional 1 woman in 369 compliant with screening receiving a cervical cancer diagnosis during her lifetime, and an additional 1 in 1,639 dying of cervical cancer. The authors believe that a significant number of patients and providers would not choose to accept these additional risks if they understood them, despite the recognition of potential harms associated with more intensive screening.
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