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Independents' Day

GPs set to drop smears in under-25s

The national cervical cancer screening programme is set for an overhaul with GPs likely to be told to abandon smear tests for women under 25.

Under the planned chan-ges, GPs would have to offer screening every three years to women aged 25-49 and every five years to those aged 50-64.

The recommendations were made by Government-

commissioned researchers who were asked to identify the most cost-effective screening interval for smear tests in a bid to iron out geographical variations.

Their conclusions were unveiled last week by the NHS Cancer Screening programme. Its expert group is likely to rubber-stamp the proposed changes later this month.

GP cancer experts predicted the changes would have a 'variable' impact on GP workload depending on how often their PCT currently invites women for screening. Latest official figures show 60 per cent of areas offer screening every three years, with the remaining 40 per cent opting for a five-year screening interval or a mixture of the two.

The new research, published in this month's British Journal of Cancer, showed screening women aged 25-49 every three years offered 84 per cent protection against cervical cancer compared with 73 per cent for five-yearly screening.

In older women, screening every five years conferred 83 per cent protection. Three-yearly or even annual screening added little extra benefit.

The audit analysed the screening histories of 4,000 women, including 1,300 diagnosed with cervical cancer.

Study leader Professor Peter Sasieni, professor of biostatistics and cancer epidemiology at Cancer Research UK, said the recommended chang-es would see the screening programme prevent 'a slightly greater' number of cancers without any increase in the overall number of screening invitations sent out.

'Hopefully it will make it easier for GPs to confidently tell older women it is safe for them to wait five years before their next smear. Having a uniform policy across the country should also reduce the time spent explaining why screening intervals in other practices are shorter or longer,' he said.

Dr Pawan Randev, a GP in Amersham, Buckinghamshire, and a former member of the Government's cancer referral guidelines steering group, said the impact on GP workload would be 'variable'.

Recommended changes to smear tests

Age of woman Screening interval

Under 25 Do not screen

25-49 Every three years

50-64 Every five years

65+ Only if not screened since age 50

Source: British Journal of Cancer (July)

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