Benefit of cervical screening at different ages: evidence from the UK audit of screening histories

Br J Cancer. 2003 Jul 7;89(1):88-93. doi: 10.1038/sj.bjc.6600974.


While most experts agree that cervical screening is effective, there remains controversy over the most appropriate screening interval. Annual screening is common in North America. In England, some argue for 3-yearly screening while others believe 5-yearly screening is adequate, and the frequency varies from one part of the country to another. Screening histories of 1305 women aged 20-69 years, diagnosed with frankly invasive cervical cancer and 2532 age-matched controls were obtained from UK screening programme databases. Data were analysed in terms of time since last negative, and time since last screening smear. Five-yearly screening offers considerable protection (83%) against cancer at ages 55-69 years and even annual screening offers only modest additional protection (87%). Three-yearly screening offers additional protection (84%) over 5-yearly screening (73%) for cancers at ages 40-54 years, but is almost as good as annual screening (88%). In women aged 20-39 years, even annual screening is not as effective (76%) as 3-yearly screening in older women, and 3 years after screening cancer rates return to those in unscreened women. This calls into question the policy of having a uniform screening interval from age 20 to 64 years and stresses the value of screening in middle-aged women. British Journal of Cancer (2003) 89, 88-93. doi:10.1038/sj.bjc.6600974

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Databases, Factual
  • Female
  • Health Policy*
  • Humans
  • Mass Screening*
  • Medical Audit*
  • Medical History Taking*
  • Middle Aged
  • Neoplasm Invasiveness
  • Practice Guidelines as Topic*
  • United Kingdom
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / pathology
  • Vaginal Smears