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Delayed cervical screening backed by study

Wednesday October 5th, 2016

Some women may be safe waiting longer than the currently-recommended five years between cervical screening, researchers say today.

Women over 40 who are HPV negative are at low risk, according to the new analysis by experts in the Netherlands, where new criteria are to be adopted.

The proposals seek to merge the use of HPV screening with traditional smear testing.

Dr Johannes Berkhof of the VU University in Amsterdam, says cervical screening has led to early detection of cancer.

They explain that in 2017, screening intervals in the HPV based screening programme in The Netherlands will be increased from five years to ten years for HPV negative women aged 40 years and older.

But evidence on the safety of screening intervals beyond five years is limited, so they carried out a risk assessment by examining figures from 43,339 women aged 29 to 61 years, over a 14 year follow-up. Participants were randomly assigned to either HPV and cytology testing (for their HPV status) or cytology testing alone, every five years.

Analysis suggested that rates of both cervical cancer and cervical intraepithelial neoplasia grade 3 or worse were similar in the two groups after ten years, covering two rounds of testing.

Details appear in today's (5 October) BMJ. The authors state: "Long term incidences of cervical cancer and CIN3+ were low among HPV negative women in this study cohort."

They add that the findings "support an extension of the cervical screening interval beyond five years for women aged 40 years and older".

But because HPV positive women were seen to have at least a fivefold higher risk than HPV negative women, "HPV based programmes with long intervals (greater than five years) should be implemented with risk stratification", they urge.

In the UK, women aged between 25 and 49 are currently invited for screening every three years, and up to the age of 64, every five years.

Dijkstra, M. G. et al. 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. BMJ 5 October 2016 doi: 10.1136/bmj.i4924 [abstract]

Tags: Cancer | Europe | Women's Health & Gynaecology

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