Still confused about cancer screening, and whether it's right for you?

Still confused about cancer screening, and whether it's right for you?

I've posted a lot of information in this blog, some of it more technical, but most I've tried to make as digestible as possible.

But what if you're still not sure whether screening is the right choice for you? After all, this is just an internet blog...

I can help!

Here is a very simple form that you can print out and take along to your doctor or nurse, and ask them to fill out for you. In order for you to be able to give informed consent, they should be able to give you the information required. After all, nobody can give informed consent, without being informed!

So, with this completed by your doctor or nurse, you can then decide for yourself whether the benefits of screening (the difference between the top 2 boxes, and ultimately the last box), and the risks of screening (the 3rd and 4th boxes).

If your doctor or nurse cannot give you this information, I would strongly advise refusing to be screened until they can provide it. If they don't know the risks and benefits, then they really shouldn't be offering the screening.

I hope this helps someone to make an informed choice!

Cervical screening in women under the age of 25. Worth it?

I often see and hear younger women upset that they "cannot get their smear test" until they turn 25. 

The fervour in the media, from charities with their own agendas, and sadly, from uninformed celebrities, regarding cervical screening has led to younger women wondering why they cannot be screened, and worried that they are at risk of cervical cancer.

When cervical screening was introduced in 1988, the age from which screening was offered was set at 20. This was "largely based on available data at the time". (Source: https://publichealthmatters.blog.gov.uk/2014/04/28/what-is-the-right-age-for-cervical-screening/)

Of course the UK had no cervical screening programme before this, so quite where this data came from is unclear.

In 2003, a group of expert clinicians and scientists, the Advisory Committee on Cervical Screening (ACCS), was asked to review the age from which cervical screening should be offered.

They analysed the evidence that was available from the 15 years of data now available from the active screening programme, and found that levels of abnormal cell changes were very high in the 20 to 25 year old population, however cervical cancer in this age group was actually very low indeed. Within this age group that cervix is still maturing, and the "abnormal cells" are actually very normal in this group.

So, many young women were undergoing unnecessary screening, testing and surgical treatment for no benefit, and indeed, at great risk of harm.

The age was reviewed again in 2009, and ACCS reaffirmed that screening the under-25s was harmful, and offered no benefit.

In short, all the experts agree that the risk of cervical cancer in the under-25's is so rare, and the risk of over-treatment so high, that it would cause more harm than good.

To look at the incidence by age shows that the under-25's have less risk of cervical cancer than the over 80's:

(Source: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/incidence#heading-One)

The highest risk is in the 25-29 age group, although even at this age, the risk of developing cervical cancer is only ~21 women per 100,000, or 0.021% when expressed as a percentage.

Cervical cancer is low risk disease in all cases, and in the under-25's, the risk is lower still.

Screening the under-25's can do nothing but harm. That is why they are not offered screening anymore.