Health ministers bowed to the Jade Goody effect yesterday, announcing a review of the age at which cervical cancer screening should start in England. Pressure from medical charities and the media has prompted ministers to look again at whether screening should start at 20 instead of 25.
England, where screening starts at 25, is out of line with the rest of the UK where the starting age is 20. But the Government's cancer tsar, Professor Mike Richards, said people should not anticipate the review's outcome, "Lets be clear, we have said we will undertake a formal review of the evidence. We are not committing ourselves to a change in policy," he said yesterday.
Goody, 27, a reality TV star, is thought to have only weeks to live after being told her cervical cancer is terminal. Publicity around her case has already led to a surge in demand for screening in some hospitals.
Last night, she issued a statement which said she was "immensely proud" she had helped prompt the review. "It's too late for me but it will not be for millions of others," she said.
As Goody's case draws attention to the impact of the cancer on young women, sexual health charity Marie Stopes International has demanded England lowers the age of the first cancer screening for women.
The charity said lowering the age would be a "beneficial move" as the lifestyles of young English women were changing with more engaging in unprotected sex and smoking, increasing the risk of cervical cancer.
Until 2003, cervical screening in England began at 20 but this was raised to 25 after research emerged of its negative effects. Changes to the cervix are common in women under 25 but they are mostly harmless. If detected they can lead to unnecessary treatment, with the removal of tissue from the cervix increasing the risk of a later premature birth, especially for younger women.
The NHS cancer screening service says there are fewer than 50 cases of cancer a year in the under 25s (1.7 per cent of all cervical cancers in women under 70) and fewer than five deaths.
England followed international guidelines on the age for screening, Professor Richards said. "We are plumb in line with the World Health Organisation recommendations which were obviously made by a large group of experts. There is [international] variation with some countries starting as early as age 18 and some as late as 30. But incidence figures change, the data change and we need to be sure we are where we should be. We will look at the potential benefits and harms of screening from age 20, trends in epidemiology in that age group, the future impact of HPV vaccination and what evidence we have got of the impact on the 25 to 34 age group where there has probably been the greatest benefit from the publicity round Jade Goody."
The number of under-35s coming for cervical smear tests has been falling since the late 1990s. In the past decade, coverage of 25 to 29-year-olds has declined from 79 per cent to 66 per cent and in 30 to 34-year-olds it has fallen from 84 per cent to 77 per cent. The Health minister, Ann Keen, said: "Cervical screening saves 4,500 lives every year and we want to ensure that our programme remains in the best interests of young women."
Katie Brickell: If a woman under 25 wants a test, she should have one
Case study
A woman who was refused a smear test three times because she was "too young", yet who went on to develop cervical cancer, welcomed the news that ministers are to review the age limit. Katie Brickell, 25, from Haywards Heath, West Sussex, said she was "over the moon" that the issue was being taken seriously.
She said: "I am really pleased that they have recognised it was the wrong decision to raise it. If a woman under 25 wants a smear test, they should be allowed to have it."
She said she was pleased the issue was being looked at but said it was a shame that it took something like Jade Goody's high-profile battle to get it on the Government's agenda.
Mrs Brickell, who campaigns to have the age limit for smears lowered, said: "I think it's awful what has happened to Jade but at least it's something positive that has come out of Jade's ordeal."
Mrs Brickell, a former account executive for a city insurance broker, requested a smear test when she was 19 and studying biology at Sussex University, but was told she would have to wait until she was 20. She returned at 20 but was told the limit had changed to 25.
Mrs Brickell thought little more about it until March last year when she suffered discharge and went for tests at a sexual health clinic. An emergency smear test revealed that she had cervical cancer, which spread to her lymph nodes and lungs.
She married her boyfriend, Rolan, in October last year. Since then, Mrs Brickell has responded well to treatment and doctors hope to have the cancer under control.
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