Evaluation of: Sasieni P, Castanon A, Cuzick J: Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 339, B2968 (2009). In a large case-control study with cases identified from centers across the UK and using data from the NHS database (collected between 1990 and 2008), investigators evaluated the effectiveness of cervical screening with Pap tests, with a particular focus on women aged 20-24 years. Screening of these young women had little or no effect on the rates of invasive cervical cancer up to 30 years of age. However, screening older women (aged 35-64 years) was shown to reduce cervical cancer risk by approximately 60-80%. This study suggests that the screening age can be safely raised to 25 years without causing harm. Along with the information from this study, policymakers should consider the harms of screening at different ages as well as the absolute rate of cervical cancer in screened and unscreened women of different ages.
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