Cervical screening every five years as good as all three

The frequency of cervical screening could be changed to every 5 years instead of 3 years

Researchers have called the results “reassuring” (Picture: Getty)

Screening for cervical cancer every five years instead of every three years could still prevent as many cancers, a new study suggests.

Researchers at King’s College London (KCL) have said that screening women and people with a cervix aged 24 to 49 who test negative for human papillomavirus (HPV) every five years is just as effective as screening every three years.

The study, published today in the British Medical Journal, looked at data from 1.3 million women in England.

It found that people aged 24 to 49 three years after a negative HPV screen were less likely to have cervical lesions, abnormal changes in the cells lining the cervix known as CIN3+, and cervical cancer compared to a negative smear test develop.

Invitations to cervical exams in England are currently sent out every three years to women and people with a cervix aged 25-49 and every five years to those aged 50-64.

The KCL researchers said that high-risk HPV DNA is found in more than 99% of all cervical cancers.

Before 2019, cytology tests, also called swab tests, first checked cervical cells for abnormalities, but now samples are first tested for HPV.

The KCL team said HPV testing detects more people at risk for cervical cancer because HPV infection occurs before abnormal cells develop.

File photo dated 19/05/08 of a woman looking at matter under a microscope. There has been a steep increase in cervical cancer rates among women aged 25 to 29, a charity warns. PA photo. Issue date: Wednesday January 22, 2020. New figures show a decade-long lack of progress in tackling the disease, with worryingly low numbers of women taking part in screening, according to Cancer Research UK. See PA story HEALTH Cervical. Photo credit should read: David Davies/PA Wire

Before 2019 swab samples were first checked for abnormal cells, now they are first screened for HPV (Image: PA)

The lead author Dr. Matejka Rebolj, chief epidemiologist at KCL, said the results were “very reassuring”.

“They build on previous research showing that after the introduction of HPV testing for cervical screening, a five-year interval is at least as safe as the previous three-year interval,” she added.

“By moving to five-yearly screening, we can prevent just as many types of cancer as before while allowing fewer screenings.”

Researchers from KCL, the University of Manchester and the NHS analyzed data from the NHS Cervical Screening Program in England and followed screening participants for two rounds, the first from 2013 to 2016 with a follow-up until the end of 2019.

They found that people under 50 who were eligible for screening and had a negative HPV screen in the first round had a lower risk of detecting CIN3+ in the second round compared to cytological tests.

The study found that 1.21 out of 1,000 people after negative HPV screening had evidence of CIN3+, compared to 4.52 out of 1,000 people after negative cytology.

dr Rebolj said: “This monumental study drew on a multidisciplinary team, including those at the NHS Cervical Screening Program in England, who worked with women undergoing screening and their specimens, and our academic partners.

“This partnership provides evidence that will best serve the millions of women who will be invited for screening throughout most of their adult lives.

“These promising results show that most women and people with a cervix do not need to be checked as frequently as they do today.”

Michelle Mitchell, Chief Executive of Cancer Research UK, said: “This large study shows that offering cervical cancer screening with HPV testing is effective in preventing cervical cancer without the need to screen as often.

“This builds on findings from years of research showing that HPV testing is more accurate in predicting who is at risk of developing cervical cancer compared to the previous testing method.

“As changes are made to screening programs, they will be monitored to ensure cervical screening is as effective as possible for all participants.

“It’s important to remember that screening is for people without symptoms. So if you notice any unusual changes, don’t wait for an invitation to be screened — talk to your doctor.”

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Justin Scacco

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