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Cervical cancer screening for over 50 year olds continues to find abnormalities even if they have clear results in their 40s, a new study published in the British Journal of Cancer has revealed.

The results are from a cohort study of 2 million women aged between 20 and 64. Within this, the authors studied a sub-group of 57,000 women, 80 per cent of whom had at least two negative screening tests in their forties and a further test over age 50 between 1988 and 2003. The study was funded by the Department of Health Policy Research Programme.

"This study will inform the discussion about whether or not to continue screening of women over the age of 50 with a prior history of negative screening tests.  It shows that the NHS Cervical Cancer Screening is continuing to benefit older women. Nearly two thirds of serious pre-cancerous abnormalities (classified as CIN 3) currently detected in women over 50 would remain undetected without the provision of screening in this group," Dr Roger Blanks from The Institute of Cancer Research and lead author of the study says.

Currently, women aged 25 to 49 are invited for screening every three years, and 50-64 every five years by the NHS Cervical Cancer Screening Programme.

The cohort study involved residents from four health authorities, now Primary Care Trusts, in the South of England (Berkshire, Oxfordshire, Somerset and Dorset), which have a lower than average risk of cervical cancer.  This suggests that the rate of abnormalities that would be missed could be greater on a national scale.

However, benefits of screening women in their 50s need to be balanced against possible negative considerations such as over-diagnosis and potentially causing unnecessary anxiety, as well as the financial cost of screening.

"The risks of developing cervical cancer as women get older are moderately reduced, however the evidence shows that the risk of not detecting cancer or extensive pre-cancerous conditions justifies ongoing screening for this age group," Dr Blanks says.

"Long-term follow up of this cohort study will enable further analysis of women with negative histories and help us determine if there are potentially very low risk groups for whom further screening may not be necessary."

Health Minister Ann Keen says: "The cervical screening programme in England is a great success, it is internationally recognised as world class and saves up to 4,500 lives every year. We welcome this new research that shows our policy of continuing to screen women up to age 64 is correct and contributes to the number of lives saved.

"Women aged over 64 are invited for screening if they have never been screened or if their last three tests were not clear."

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