Curriculum · Screening (National/International)
Cervical cancer screening
What it is
Cervical screening looks for disease of the cervix in women who have no symptoms, and the test is the Pap smear with or without HPV testing, not pelvic ultrasound. The women covered are 21 to 65 years of age. A Pap test with cytology is repeated every 3 years, or an HPV-based test every 5 years. A different national programme is set out beside it. In the UK a smear test is offered to all women between the ages of 25-64 years, with 3-yearly screening at 25-49 years and 5-yearly screening at 50-64 years, and that programme is estimated to prevent 1,000-4,000 deaths per year. In Scotland women from the ages of 20-60 years are screened every 3 years. The ages differ from the 21 to 65 above, so hold the two as two programmes and not as one rule.
Causes and risk
The risk factors given for cervical cancer are HPV types 16 and 18, sexual activity starting at a young age, multiple sexual partners, smoking and immunosuppression such as HIV. HPV is the most common sexually transmitted infection, and up to 79% of sexually active women contract HPV infection in their lifetime, so a woman with no other sexually transmitted infection may still have an HPV infection. In women 21 to 29 years of age the prevalence of high-risk HPV infection is high while the incidence of cervical cancer is low.