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UK cervical screening programme saves 5,000 lives a year (p 224, 249)
July 14, 2004An epidemiological study in this week's issue of THE LANCET highlights the success of the UK's national screening programme for cervical cancer introduced in 1988. Authors of the study outline how the programme has prevented an epidemic of cervical cancer-around 5000 deaths are prevented every year and 100 000 (one in 80) of the 8 million British women born between 1951 and 1970 will be saved from premature death by the cervical screening programme.
Recent reports have suggested that the reduction in deaths achieved by the UK national cervical screening programme is too small to justify its costs, except perhaps in a few high-risk women. Julian Peto (Cancer Research UK) and colleagues analysed trends in deaths from cervical cancer before 1988 (when the British national screening programme was launched) to estimate what future trends in cervical cancer deaths would have been if national screening had not been introduced.
The investigators report how Cervical cancer deaths in England and Wales among women younger than 35 years rose three-fold from 1967 to 1987-largely due to increases in the transmission of human papilloma virus associated with the acquisition of sexually transmitted diseases. By 1988, incidence in this age-range was among the highest in the world. Since national screening was started, this rising trend has been reversed.
Professor Peto comments: "Cervical screening has prevented an epidemic that would have killed about one in 65 of all British women born since 1950 and culminated in about 6000 deaths per year in this country. The cervical screening programme will prevent about 5,000 future deaths each year in Britain at a cost per life saved of less than £40,000, or about £2,000 per year of extra life. Despite occasional but widely publicised failures the British cervical screening programme is already remarkably successful and is still improving."
In an accompanying commentary (p 224), David B Thomas (Fred Hutchinson Cancer Research Center, Seattle, USA) states: "Funds for disease-control programmes are often reduced or withdrawn in response to success. However, just because a disease becomes rare does not mean that control of it should stop. It might be rare because of the success of the programme being assessed. Modelling allows us to not only project the effect of an ongoing programme, but also to project what would happen to disease rates if that programme were terminated. If, as Peto and colleagues conclude, the population effect of the national screening programme is indeed great, then screening for cervical cancer should continue-even though it is no longer a major public-health issue in the UK-until a vaccine against HPV, or some other means of primary prevention becomes available. However, if the screening programme is less successful, or the costs outweigh the benefits, funds for control of the disease might be more usefully directed elsewhere."
Lancet
Professor Peto comments: "Cervical screening has prevented an epidemic that would have killed about one in 65 of all British women born since 1950 and culminated in about 6000 deaths per year in this country. The cervical screening programme will prevent about 5,000 future deaths each year in Britain at a cost per life saved of less than £40,000, or about £2,000 per year of extra life. Despite occasional but widely publicised failures the British cervical screening programme is already remarkably successful and is still improving."
In an accompanying commentary (p 224), David B Thomas (Fred Hutchinson Cancer Research Center, Seattle, USA) states: "Funds for disease-control programmes are often reduced or withdrawn in response to success. However, just because a disease becomes rare does not mean that control of it should stop. It might be rare because of the success of the programme being assessed. Modelling allows us to not only project the effect of an ongoing programme, but also to project what would happen to disease rates if that programme were terminated. If, as Peto and colleagues conclude, the population effect of the national screening programme is indeed great, then screening for cervical cancer should continue-even though it is no longer a major public-health issue in the UK-until a vaccine against HPV, or some other means of primary prevention becomes available. However, if the screening programme is less successful, or the costs outweigh the benefits, funds for control of the disease might be more usefully directed elsewhere."
Lancet
Cervical Cancer Current Events and Cervical Cancer News RSS1 disease, not 1 demographic
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Alternatively spliced tissue factor identified as promising new biomarker for aggressive cancers
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M. D. Anderson redefines screening guidelines for breast, cervical and colorectal cancers
Drawing on years of experience in cancer research and patient care, The University of Texas M. D. Anderson Cancer Center released today the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.
Study finds delay in follow-up among African-American women receiving abnormal breast finding
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UIC study finds girls aware of HPV vaccine's benefits
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Scientists identify common HPV genotypes in northern India, encourage vaccination
Although a wide spectrum of human papillomavirus is seen across the population of India, HPV-16 and HPV-18 are the most common types and a vaccination targeting these types could eliminate 75 percent of the cervical cancers in the region.
Vaccinating boys against human papillomavirus not cost-effective
Persistent infection with high-risk types of human papillomavirus (HPV), a sexually transmitted virus, is known to be a cause of cervical cancer.
Vaccination and testing for the human papilloma virus could eradicate cervical cancer
Cervical cancer could be eradicated within the next 50 years if countries implement national screening programmes based on detection of the human papilloma virus (HPV), which causes the disease, together with vaccination programmes against the virus, according to a cervical cancer screening expert.
Targeted heat therapy offers new standard treatment option for soft tissue sarcoma
Patients with soft-tissue sarcomas at high risk of spreading were 30% more likely to be alive and cancer free almost three years after starting treatment if their tumours were heated at the time they received chemotherapy, according to new research.
Even in a safety net health system, colorectal cancer screening disparities remain
Colorectal cancer screening rates are much lower among those in a safety net health system compared to the national average, and the number one predictor of screening is a combination of regular visits and insurance access.
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