Literature DB >> 9166202

The case for stopping cervical screening at age 50.

M E Cruickshank1, V Angus, M Kelly, S McPhee, H C Kitchener.   

Abstract

OBJECTIVE: To determine the pattern of abnormal cervical cytology in women aged 50 to 60 years and to determine whether the development of cervical neoplasia in this age group is confined to women who have been inadequately screened.
DESIGN: Retrospective case analysis study. POPULATION: An 11-year birth cohort of women in Grampian Region born between 2/10/33 and 1/10/44, and those who had significant cytological abnormalities in the 5 year period 1/10/89 to 30/9/94. MAIN OUTCOME MEASURES: Cytological and histological outcome for women with significant cytological abnormalities between 50 to 60 years of age and the interval between three consecutive smears taken up to 50 years of age for those women.
RESULTS: Of 23,440 women aged 50 to 60 years ever screened in Grampian Region, 229 (1%) had significant cytological abnormalities. Seventy had CIN 3 and 15 had invasive disease of the cervix. Among approximately 9000 women with adequate smear histories prior to age 50, one case of CIN 3 and one case of invasion were detected. The prevalence of invasive disease in the whole cohort during this five year period was 59/100,000. Among the previously well screened women the prevalence was 11/100,000.
CONCLUSION: The incidence of preinvasive disease of the cervix is low over the age of 50 and is seen almost exclusively in inadequately screened women. There would appear to be little benefit in continuing cervical screening over the age of 50 in women who have had regular negative smears. The release of this low risk group from the cervical screening programme could alleviate anxiety and could enable reallocation of resources to target better high risk women who default from regular screening and to reduce screening intervals where necessary to three years.

Entities:  

Mesh:

Year:  1997        PMID: 9166202     DOI: 10.1111/j.1471-0528.1997.tb11537.x

Source DB:  PubMed          Journal:  Br J Obstet Gynaecol        ISSN: 0306-5456


  8 in total

1.  Withdrawing low risk women from cervical screening programmes: mathematical modelling study.

Authors:  C Sherlaw-Johnson; S Gallivan; D Jenkins
Journal:  BMJ       Date:  1999-02-06

Review 2.  Gynaecological cancer.

Authors:  H C Kitchener
Journal:  Postgrad Med J       Date:  1999-06       Impact factor: 2.401

3.  Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

Authors:  Truls Ostbye; Gary N Greenberg; Donald H Taylor; Ann Marie M Lee
Journal:  Ann Fam Med       Date:  2003 Nov-Dec       Impact factor: 5.166

4.  Incidence of cervical cancer after several negative smear results by age 50: prospective observational study.

Authors:  Matejka Rebolj; Marjolein van Ballegooijen; Elsebeth Lynge; Caspar Looman; Marie-Louise Essink-Bot; Rob Boer; Dik Habbema
Journal:  BMJ       Date:  2009-04-24

5.  Risk of cervical abnormality after age 50 in women with previously negative smears.

Authors:  R G Blanks; S M Moss; S Addou; D A Coleman; A J Swerdlow
Journal:  Br J Cancer       Date:  2009-05-05       Impact factor: 7.640

6.  Do women >or=50 years of age need as much screening as women <50 years after they have had negative screening results?

Authors:  P Armaroli; F Gallo; A Bellomi; S Ciatto; D Consonni; D Davi; P Giorgi-Rossi; A Iossa; E Mancini; C Naldoni; E Polla; G Ronco; M Serafini; V Vergini; L Zanier; M Zappa; N Segnan
Journal:  Br J Cancer       Date:  2008-07-01       Impact factor: 7.640

7.  Effect of ageing on cervical or vaginal cancer in Swedish women previously treated for cervical intraepithelial neoplasia grade 3: population based cohort study of long term incidence and mortality.

Authors:  Björn Strander; Jonas Hällgren; Pär Sparén
Journal:  BMJ       Date:  2014-01-14

8.  Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature.

Authors:  I Kalliala; A Athanasiou; A A Veroniki; G Salanti; O Efthimiou; N Raftis; S Bowden; M Paraskevaidi; K Aro; M Arbyn; P Bennett; P Nieminen; E Paraskevaidis; M Kyrgiou
Journal:  Ann Oncol       Date:  2020-01-03       Impact factor: 32.976

  8 in total

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