A study, published in The BMJ, details evidence that supports extending the cervical cancer screening interval beyond five years for women aged 40 years and older.
The study included 43,339 women, between the ages of 29 and 61 years, with a negative human papillomavirus and/or negative cytology test. These women were randomly assigned to HPV and cytology co-testing or cytology testing only. One of the main outcome measures was the cumulative incidence of cervical cancer and cervical intraepithelial neoplasia grade 3 or worse (CIN3+).
Here are five findings:
1. The cumulative incidence of cervical cancer and CIN3+ among HPV-negative women in the co-testing group after three rounds of screening was similar to the cumulative among women with negative cytology in the control group after two rounds.
2. Cervical cancer and CIN3+ risk ratios were 0.97 and 0.82, respectively.
3. CIN3+ incidence was 72.2 percent lower among HPV-negative women aged 40 years and older as compared to younger women.
4. The findings did not demonstrate any significant association between cervical cancer incidence and age.
5. HPV-positive women with subsequent negative cytology, HPV16/18 genotyping, and/or repeat cytology have at least a five-fold higher risk of CIN3+ than HPV-negative women. This indicates that "HPV-based programs with long intervals (greater than five years) should be implemented with risk stratification," according to the study.