Cervical Cancer Risk Warning

Women under 25 could be at greater risk of developing cervical cancer because they are not offered smear tests, experts say. A change of policy in 2004 means women are now invited for their first smear test at 25 instead of 20.

Health chiefs argue that cervical cancer is rare in under-25s, and screening such young women “may do more harm than good”. But consultant pathologists Amanda Herbert, from Guy’s and St Thomas’ NHS Foundation Trust in London, and John Smith, from the Royal Hallamshire Hospital in Sheffield, believe the new policy could be putting women at risk.

In a letter to the British Medical Journal (BMJ), they said women now started having sex at a younger age and may therefore experience serious cell changes when they are between 20 and 24. Smear tests pick up changes in the cells of the cervix, with the most serious, CIN3, being a precursor to cancer.

The authors write: “Prevalence of carcinoma in situ (CIN3) has increased in women aged 20-24, which is consistent with more women in recent birth cohorts starting sexual activity in their mid-teens. The new policy will add more than 3,000 women with untreated CIN3 to the larger numbers failing to accept their invitations later on.”

Screening in the UK had been “highly successful” but this was due to treating high-grade CIN, especially CIN3, in young women before cancer developed, they say.

Women aged 25 to 29 are most likely to have CIN3, but coverage among that age group has fallen the most, the authors say.