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Age for first smear test raised to 25

THE age when women in Scotland are first invited for smear tests is to be raised from 20 to 25 following a review of the evidence in support of the screening programme.

The change will come into effect from 2015, bringing the NHS in Scotland into line with current practice in England and Northern Ireland.

It follows recommendations published today by the UK National Screening Committee (NSC), a panel of cancer and public health experts, that evidence surrounding the effectiveness of screening supports increasing the age when women are first invited for a smear test from 20 to 25. Wales – the only other UK country which currently begins screening at 20 – is also expected to increase its threshold to 25.

The NSC has also advised women over 50 should be invited every five years, rather than every three years, and the upper age of screening should be extended to 64 years of age.

The Scottish Government will fully implement the recommendations from 2015, when the first cohort of girls vaccinated against the human papilloma virus – the virus which cause cervical cancer – will reach screening age.

Michael Matheson, Minister for Public Health, said: “Cervical screening has proven to be an effective method of reducing the incidence and mortality of cervical cancer, and in detecting cancer as early as possible.

“It saves around 5000 lives in the UK every year and prevents eight out of 10 cervical cancers from developing.

“We take our advice on screening from the National Screening Committee, and their recommendations are based on strong evidence.

“These recommendations also reflect the recommendations of the Expert Group in Scotland, which recently reviewed the age range and frequency of screening within the Scottish Cervical Screening Programme.”

The move also reflects a shift in attitude around screening among cancer charities and campaigners. In the wake of Big Brother star Jade Goody’s death from the disease in 2009, aged 27, there were calls for the age limit to be reduced to 20 in England and Northern Ireland to match the practice elsewhere in the UK.

However, the debate has since turned around with charities including Jo’s Trust and the Eve Appeal – previously vocal campaigners in favour of reducing the age – now backing screening from 25. The shift follows mounting evidence that screening women under 25 – when the rates of cervical cancer are extremely low – could do more harm than good by picking up abnormalities that would otherwise clear up on their own and exposing very young women to unnecessary tests and treatment.

Jess Harris, Cancer Research UK’s health information manager, said: “This announcement is good news for women. Screening programmes need to make sure the benefits of taking part outweigh the risks, such as unnecessary tests and worry.

“Changes picked up by cervical screening in women under the age of 25 mostly clear up on their own. The introduction of HPV vaccination in 2008 has also changed the picture for younger women, offering them immunity to the virus that causes around seven in 10 cases of cervical cancer.”

Robert Music, director for Jo’s Cervical Cancer Trust, said: “[We] will continue to focus on cervical cancer prevention and early detection and two examples include increasing the numbers of women who are eligible to take up their cervical screening invitation as well as encouraging a greater awareness of the symptoms of cervical cancer.

"Following concerns over screening uptake across the UK the charity has worked to understand the barriers to why so many women are not taking up their invitation. Consequently we are taking steps to encourage eligible women to attend their cervical screening test and reduce their risk of cervical cancer."

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