Screening and sex ed can beat cervical cancer

Between 2006 and 2008 the incidence of the disease rose by 43 per cent in this age group. This is particularly distressing because cervical cancer is a largely preventable disease, thanks to cervical screening.

While no clear reasons for this failure were given, we know that the number of women having smear tests has been falling steadily since 2009.

In fact, only two-thirds of those aged 25 to 29 in England have been screened within the past five years, down from 75 per cent in 2001. There will be many other reasons, of course, including an increase in unprotected casual sex among young women and the younger age at which they start having it.

In little more than a decade's time, most 25-year-old women will have been vaccinated against high-risk strains of human papilloma virus (HPV), the cause of cervical cancer, which should have highly beneficial implications for the UK screening programme. But until then, screening is the best defence.

There is a campaign going on to lower the age (currently 25) at which screening is offered but I can't see the benefit. It is true that, albeit rarely, young women do develop cervical cancer, and screening at a younger age will detect pre-cancerous changes, but it will also pick up much benign change, not a risk for cancer but which will have to be treated anyway, causing possible future problems. Women under 25 are likely to have cervical abnormalities, but most will resolve harmlessly without any need for intervention. Treatment can weaken the cervix and women who become pregnant after treatment for an abnormal smear are at an increased risk of giving birth prematurely.

If anything needs changing, it is the type of screening test. The UK uses liquid-based cytology - putting cells from the cervix into liquid that is then examined under a microscope.

But scientists now have a more sensitive screening method by testing for the presence of HPV.

I believe we should also include cervical cancer when teaching about sexually transmitted infections. We warn about chlamydia and gonorrhoea, but rarely about cervical cancer, which is almost always precipitated by infection with sexually transmitted human papilloma virus.

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