The English NHSCSP recommendation not to offer cervical screening to women is considered in the context of national rates of CIN3 and invasive cervical carcinoma, falling screening coverage in young women, detection of screen-detected invasive cancers, and risks of excisional treatment of CIN.
Registrations of invasive and in situ cervical carcinoma were obtained from the Office for National Statistics, data on screening coverage and cytology results from the NHSCSP website, and data on screen-detected cancers from an audit GSTFT.
Before and after introducing organized screening in England, CIN3 was primarily detected in women. The peak incidence of invasive cancer in screening age groups is now 35–39 years. At GSTFT in 1999–2006, 24 of 32 cancers in women were screen-detected, and that percentage declined in subsequent 15-year age bands.
The study concluded that delaying the age for screening eligibility carries a risk of CIN becoming more extensive, more difficult to excise, and a chance of progression. The NHSCSP should reconsider its decision and encourage young women to be screened, not excluding those aged 20–24. Facilities for taking the tests should be made more convenient.