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Extending cervical screening beyond 5 years safe for some women

Extending the cervical cancer screening interval beyond 5 years for women aged 40 and over who test negative for human papilloma virus (HPV) is safe, say researchers.
cervical

Extending the cervical cancer screening interval beyond 5 years for women aged 40 and over who test negative for human papilloma virus (HPV) is safe, say researchers

The team from the Netherlands who carried out the study believe their results mark the first step towards risk-based screening, but they do not recommend extending cervical cancer screening intervals for women who test positive for HPV.

In the UK, women aged 25-49 are invited for screening every three years, and up to the age of 64, every five years. Evidence on the safety of screening intervals beyond five years is limited.

Better protection

Previous trials have shown that screening for HPV leads to earlier detection of abnormal cells known as cervical intraepithelial neoplasia (CIN)

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Extending the cervical cancer screening interval beyond 5 years for women aged 40 and over who test negative for human papilloma virus (HPV) is safe, say researchers


The researchers who carried out the study say it marks the first
step towards risk-based screening. Picture: Alamy

The team from the Netherlands who carried out the study believe their results mark the first step towards risk-based screening, but they do not recommend extending cervical cancer screening intervals for women who test positive for HPV. 

In the UK, women aged 25-49 are invited for screening every three years, and up to the age of 64, every five years. Evidence on the safety of screening intervals beyond five years is limited. 

Better protection 

Previous trials have shown that screening for HPV leads to earlier detection of abnormal cells – known as cervical intraepithelial neoplasia (CIN) – than cytology testing, and offers better protection against cervical cancer.

CIN is divided into grades 1, 2 or 3. The higher the number, the more of the cervix is affected by abnormal cells.

For the study, more than 43,000 women aged 29-61 were randomly assigned to receive both HPV and cytology testing (intervention), or cytology testing only (control). Women received three cervical screening rounds, each undertaken every five years.  

Amsterdam study

Researchers from the VU University Medical Centre in Amsterdam based their findings on a 14-year follow up period. They found that HPV-negative women aged at least 40 have a low risk of CIN 3 in the long term.

But they stress that for HPV-positive women, the long term risk of CIN 3 is too high to support extending screening beyond five years.


Dijkstra GM et al (2016) Safety of extending screening intervals beyond five years in cervical screening programmes with testing for high risk human papillomavirus: 14 year follow-up of population based randomised cohort in the Netherlands. The BMJ. doi: http://dx.doi.org/10.1136/bmj.i4924

 

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