Abstract
Age at which women are first invited to attend cervical screening in England has changed twice: in 2004, women under 25 years were no longer invited; and in 2012, first invitations were sent six months earlier (at age 24.5 years). Concomitantly, a dramatic increase in screen-detected cervical cancer was observed, and their survival had not been documented. Diagnoses of invasive cervical cancer at ages 20–29 years in 2006–2016 in England were followed until the end of 2018 for deaths. We estimated 8-year overall survival (OS) by International Federation of Gynecology and Obstetrics (FIGO) stage and age at first screening invitation. Overall and relative survival for stage IA cervical cancer for women diagnosed aged 20–29 years in England (n = 1905) was excellent at 99.8% (95% confidence intervals (CI): 99.4–99.9%) and 100% (95% CI: 99.7–100.1%), respectively. OS for stage IB cervical cancer (n = 1101) was 90.4% (95% CI: 88.3–92.2%). Survival from stage IB was worse for women diagnosed age 20–24 years compared to those diagnosed 25–29 years at diagnosis (p < 0.0001), but no difference was observed by age at first invitation for screening, p = 0.8575. OS for stage II (65.5%, 95% CI: 60.2–72.0%) and stage III+ (36.6%, 95% CI 28.4–44.7%) were poorer. Survival from stage I cervical cancer in young women in England is excellent: mortality in women with stage IA cancer is akin to that of the general population regardless of age at first invitation to screening.
Highlights
The National Health Service (NHS) Cervical Screening Program in England invites women aged25–49 years for cytology screening every three years and women aged 50 to 64 years every five years.Over the last 15 years, the age at which women get their first invitation to attend cervical screening has changed twice: once in 2004, and again toward the end of 2012
2006and and2016, 2016,there therewere were4322 eligible cervical cancers diagnosed in women
Between eligible cervical cancers diagnosed in women agedaged
Summary
Over the last 15 years, the age at which women get their first invitation to attend cervical screening has changed twice: once in 2004, and again toward the end of 2012. In 2004, the age of first cervical screening invitation in England was increased from 20 to 25.0 years [1]. In 2012, the age of sending out the first screening invitation changed once more: this time to 24.5 years (to enable women to be screened by their 25th birthday) [2]. While rates of cervical cancer in other age groups have remained stable, rates among women aged 25–29 have increased from about 10 to 22 per 100,000 between 2005 and 2015. Mortality from cervical cancer under age 30 has remained stable. Between 2013 and 2016, mortality rates per 100,000 were 0.3 at ages 20–24 years and 1.3 at aged 25–29 years [3]
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