The case for stopping cervical screening at age 50

Margaret Eleanor Cruickshank, Valerie Christine Angus, M Kelly, S McPhee, H C Kitchener

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    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 CM 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.

    Original languageEnglish
    Pages (from-to)586-589
    Number of pages4
    JournalBritish Journal of Obstetrics and Gynaecology
    Volume104
    Issue number5
    Publication statusPublished - May 1997

    Cite this

    Cruickshank, M. E., Angus, V. C., Kelly, M., McPhee, S., & Kitchener, H. C. (1997). The case for stopping cervical screening at age 50. British Journal of Obstetrics and Gynaecology, 104(5), 586-589.