Impact of changes to cervical screening guidelines on age and interval at which women are tested: Population-based study

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Abstract

BACKGROUND: English cervical screening programme guidelines changed between 2009 and 2012. We explore the impact on the age and intervals at which women receive a cytology test.

METHODS: Eligible women were controls from a population-based case-control study in England. Tests taken between 1980 and 2017 were extracted from the call/recall database. Using the Kaplan-Meier estimator by birth cohort and age at (or time since) last test, we explore proportions tested since or prior to a given age, years since previous test, and interval following a negative test.

RESULTS: Screening histories from 46,037 women were included. Proportion tested by age 26 has increased from 55% among birth cohorts 1978-1979 to 67% among those born 1990-1991, despite more recent cohorts only having received one invitation (instead of two) prior to age 26. The proportion of women tested at aged 28 with a test three years earlier increased by 20% (from 36% in 1997-2006 to 56% in 2012-2017) whereas the proportion tested at ages 23-27 without a prior test increased from 34% to 80%. The age at last test prior to exiting the programme has decreased: among those born 1928-1931 86% had a test aged 60-65, but only 71% of those born 1947-1951.

CONCLUSION: Clear programme guidance alongside quality assurance has improved the cervical screening programme by standardising the age and intervals at which women are screened.

Original languageEnglish
Article number969141320953446
JournalJournal of Medical Screening
Early online date30 Aug 2020
DOIs
Publication statusE-pub ahead of print - 30 Aug 2020

Keywords

  • Cervical cancer screening
  • Kaplan–Meier
  • age at screening
  • organised screening
  • screening intervals

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