Smear test rationing 'is costing young lives'

Unlike many cancers, cervical cancer is most common in women aged between 25 and 29, with the majority of those dying from the disease being under 45. Photo / iStock

NHS rationing of cervical cancer screening has led to a rise in the number of young women dying from the disease, a leading doctor has claimed.

Consultant gynaecologist Angus McIndoe says limiting the checks to those aged 25 and over is costing young women their lives, and forcing others to undergo radical treatment that robs them of their chance of motherhood.

Unlike many cancers, cervical cancer is most common in women aged between 25 and 29, with the majority of those dying from the disease being under 45.

Smear tests pick up cells in the cervix, or lining of the womb, that could become cancerous and are credited with saving up to 5,000 lives a year in the UK.

But in 2004 the five-minute tests were scrapped for 20 to 24 year-olds, and since then the number of deaths in young women has soared.

Between 2001 and 2003, there were 12.6 cases per 100,000 women aged 25 to 34, official figures show.

By 2010 to 2012 the figure stood at 18.1 per 100,000 - a 44 per cent rise. The number of deaths among 25 to 29 year olds has risen by 25 per cent - from 1.2 per 100,000 in 2001-3 to 1.5 per 100,000 in 2010-12.

Mr McIndoe, of the Nuada Gynaecology clinic in London's Harley Street, says that starting screening from 20 would mean cases are caught early when they are easiest to treat. This would save lives and spare women the need for hysterectomies and radiotherapy that prevent them getting pregnant.

The NHS argues that the disease is very rare in under-25s and the results of smear tests are unreliable in very young women, which could lead to them undergo unnecessary treatment.

However many experts say the 2004 decision is flawed. Mr McIndoe claims it was based on 'dodgy calculations' and that ensuring a woman has had two or three tests by her mid to late twenties will greatly boost the odds of the disease being spotted.

'I think the guidance is leading to lives being lost,' he said. 'Plus, for a 25-year-old woman to have a hysterectomy and lose the chance of having children is devastating.'

Others say advice that screening is 'harmful below 25 but essential above this age' is confusing.

With the number of 25 to 29-year-olds getting screened falling to less than two-thirds in the last decade, 'abandoning [this] conflicting message ... might help reverse this trend,' said consultant Dr Amanda Herbert in the British Journal of Obstetrics and Gynaecology
One young woman to suffer from the lack of screening for under-25s is Alexandra Parker, who was repeatedly turned down for a smear test. When she finally saw a consultant at 23 - four years after first visiting her GP with abdominal problems - it was feared she had full-blown cervical cancer.

Miss Parker, now 27, from Doncaster, said: 'The consultant said to me that if she was to diagnose me based on my symptoms, she would say I had cancer.

'It felt like the room was closing in on me. I just assumed I was going to die.' A smear test revealed that although she didn't have the disease, cells in the lining of her womb were fast turning cancerous and needed to be removed.

The violinist later needed emergency surgery after she started to bleed uncontrollably at night.

Last night a Public Health England spokesman said: 'Cervical cancer ... under the age of 25 is very rare. Younger women often undergo natural and harmless changes in the cervix that screening would identify as cervical abnormalities.

'Evidence has shown that screening women under ... 25 may do more harm than good as it can lead to unnecessary and harmful investigations and treatments which could have an adverse effect on their future childbearing ... therefore, this risk outweighs any benefit.'
© Daily Mail