Dramatic increase in cervical cancer registrations in young women in 2009 in England unlikely to be due to the new policy not to screen women aged 20–24

Abstract

To explore whether the 17% increase in cervical cancer in England in 2009 was due to the change in cervical screening policy. Trends in incidence of cervical cancer and of cervical intraepithelial neoplasia grade 3 (CIN3) were analysed for England, Wales and Scotland. Invasive cervical cancer data on 4079 cancers in women aged 20-39 diagnosed between April 2007 and August 2011 in England were analysed by single year of age. In England there was a 38% (95% confidence intervals [CI] 18-62%) increase in cervical cancer incidence rates in women aged 25-29 in 2009 relative to 2008, and a 30% (11-51%) increase in women aged 35-39. Compared rates in 2010 are similar to those in 2008. The average increase between 2000 and 2010 in women aged 25-29 was no greater in England than in Scotland and Wales (relative risk 0.98, 95% CI 0.69-1.39). In England there has been a gradual increase in CIN3 (particularly for ages 25-29) since 2003, with a more dramatic increase in 2009, but a fall in 2010. Audit data showed an increase in cancers diagnosed at age 25 in 2009/2010 and 2010/2011 (P ≤ 0.0004). No increase was observed at age 26. For ages 27-29 an increase in cancer was observed for 2008/2009-2009/2010 when compared with 2007/2008-2010/2011 (P < 0.00001), but linear trends were not significant. The increase in cervical cancer in England in 2009 cannot be attributed to the lack of screening of women aged 20-24, or to a general decrease in the coverage or quality of cervical screening.