New research in BJOG: An International Journal of Obstetrics and Gynaecology , has reiterated the need for women to undergo regular smear tests to help prevent cervical cancer developing.
Researchers from New Zealand gained access to the medical records of 371 women and interviewed 359. Women between 20 – 79 years old were studied. The purpose of the study was to examine the frequency of screening in the 7 years prior to diagnosis and to determine if screening over a period of time could help detect abnormal smears or symptoms for appropriate diagnosis.
This research revealed how 50% of participants did not have a screening smear in the 3 years prior to diagnosis and around 80% were inadequately screened. Other findings were: older women were less well screened, women with lower levels of education, lower incomes, and those living in high deprivation areas; were similarly poorly screened.
Researchers point out that not all cases of cervical cancer can be prevented by screening since there are other factors which can lead to wrong diagnoses such as missed abnormal smears, delays in the investigation of abnormal smears or bleeding. However, regular screening can reduce the incidence of cervical cancer occurring in the future since it is an effective method to reveal and prevent cancerous cells from spreading.
A report which accompanied the study recommended the establishment of a population based register within the New Zealand National Cervical Screening Programme to improve invitation and recall for screening, and the use of new technologies such as liquid-based cytology (LBC) to collect smear samples.
Dr Patricia Priest from the Department of Preventive and Social Medicine at the Univeristy of Otago, who led the study, said “ Our study has confirmed that lack of screening, and more importantly of regular screening, is the most common contributing factor to cervical cancer, with many more women inadequately screened (80%) than having a missed smear (11%).”
“Screening is poorer in disadvantaged groups, which contributes to their higher rates of cervical cancer. Screening programmes need to place particular emphasis on addressing barriers to women's access to screening, and on making screening at an appropriate interval accessible and acceptable to all women, but especially to those disadvantaged groups.”
“An effective national population based invitation and recall system can do much to optimise a cervical screening programme and thus reduce the incidence and mortality from cervical cancer.”
Professor Philip Steer, BJOG editor-in-chief, said “This is valuable research since it highlights the groups of women who are most at-risk of slipping through the smear screening net, namely older women and those who are economically and socially disadvantaged.”
“The UK's NHS Cervical Screening Programme is considered successful because of the extensive coverage among the 25 – 64 target age group and this has led to a fall in death rates through cervical cancer. This piece of research proves that we should never be complacent in our monitoring and provide equal access to smear screening to women from all backgrounds.”
12 April 2007
Ends
Editor's notes
BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ‘ BJOG ' or ‘ BJOG: An International Journal of Obstetrics and Gynaecology ' when referring to the journal.
More information about the NHS Cervical Screening Programme can be found via the link http://www.cancerscreening.nhs.uk/cervical/#whatdoes
References
Priest P, Sadler L, Peters J, Crengle S, Bethwaite P, Medley G, Jackson R. Pathways to diagnosis of cervical cancer: screening history, delay in follow up, and smear reading. BJOG 2007; 114:398–407. doi:10.1111/j.1471-0528.2006.01207.x
For more information, please contact the RCOG press office on 020 7772 6446 or 020 7772 6357.
