Smear test apartheid: English women denied screening given to patients in Scotland and Wales

Women aged 20 to 24 were excluded from the NHS screening programme in 2004 - but only in England.

In the latest example of medical apartheid, young women in Wales and Scotland are still getting regular checks that mean precancerous cells can be treated before they become dangerous.

Once the disease takes hold, treatment is more complex and costly, may impair the chance of having children and could be too late for 'full-blown' cancer to be detected.

Around 4,000 cases a year are reported among the under-25s and the figure is rising.

Now doctors and campaigners want NHS smear tests brought back for English women under 25 as lives are being put at risk.

Pamela Morton, director of the cervical cancer charity Jo's Trust, said: "Hundreds of women in their early 20s contact Jo's Trust every year.

"Some because they have been diagnosed with cervical cancer, others ask why they are not eligible for a smear test or worse, why they have been refused one, simply because they are not yet aged 25."

Under the NHS screening programme in England, women aged 25 to 49 are offered smears every three years while women aged 50 to 64 years get five-yearly checks.

Those aged 20 to 24 were omitted partly because invasive cancer is "relatively rare" in this age group.

But research in the Journal of Family Planning and Reproductive Health Care shows up to 4,000 cases of serious high-grade disease were diagnosed in this age group through screening in 2003.

And the ban was based on statistics which did not take into account more smoking by teenage girls and earlier sexual activity - which both increase the risk of cervical abnormalities.

Serious cases, known as CIN3, signal the most severe pre-cancerous change and immediate precursor to cervical cancer, but they are no longer counted.

The research says the English ban also delays treatment for abnormalities which can affect fertility, said Dr Amanda Herbert of Guy's and St Thomas' NHS Foundation Trust in London.

She said: "Some abnormalities regress but CIN3 doesn't, and later diagnosis means more treatment."

Exclusion of younger women also downgrades the importance of smears for women in their late 20s. Figures show 66 per cent of women aged 25-29 regularly have smears, down 14 per cent in a decade.

Julietta Patnick, director of the NHS Cancer Screening Programmes, said: "Cervical cancer in under-25s is extremely rare, but changes in the cervix are common.

"This can result in unnecessary invasive treatments, which can result in unwarranted anxiety."