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Smear tests urged in under-25s

Specialists have called for GPs to ignore official guidance and continue to screen high-risk under-25s for cervical cancer amid rising rates of pre-cancerous abnormalities in young women.

Latest figures show the prevalence of carcinoma in situ (CIN3) in women aged 20 to 24 has leapt by 43 per cent in just over a decade, raising fears that the current screening guidelines could leave women at risk.

A letter in the latest issue of the BMJ warned that raising the age threshold to 25 could be contributing to the falling uptake of cervical screening. It urged GPs to continue to screen women who had been sexually active from a young age.

Dr Amanda Herbert, consultant cytopathologist at St Thomas' hospital in London, wrote that the national cervical screening programme gave young women the impression that screening in the 20 to 24 age group 'did more harm than good, which is unlikely to encourage them to accept their invitation' once they reached 25.

'It is worrying that quite a lot of high-grade lesions will not be treated. GPs and clinics should not be prevented from screening women whom they believe to be at risk if those women themselves want to be screened.'

The call follows news that GPs in Cheshire have been instructed they have no business screening women under 25 as the group are not at significant risk.

Dr Sarah Jarvis, a GP in Shepherd's Bush in west London and women's health spokesperson for the RCGP, said she was 'not surprised' to see the letter.

She added: 'I don't feel particularly strongly that we should lower the age at which we begin routine screening to 20. But we should be very wary of assuming that just because we don't screen women under 25 routinely, we shouldn't test those aged 20 to 24 who have been sexually active from a young age.'

Dr Richard Winder, deputy director of the NHS cervical screening programme, insisted: 'The programme's policy to screen women from the age of 25 is based on robust, independent research. The programme is always alert to new evidence when it becomes available.'

But a spokesperson for the programme said it was 'not considering any change in policy'.

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