Petition Lower the recommended age for a cervical smear test to 18.

We would like to thank you for taking the time out to raise this important issue by starting your petition.

The UK National Screening Committee (UK NSC) advises ministers and the NHS in all four countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria. In 2012 the UK NSC recommended that the age of the first invitation for cervical screening should be 25. This was based on evidence that a large number of women below this age received relatively little benefit from being screened and treated. It is only where the offer to screen provides more good than harm that a screening programme is recommended. This UK NSC recommendation also concurred with a major review by the Advisory Committee on Cervical Screening in 2009.

The NHS offers cervical screening to all eligible women aged 25 to 49 every three years and those aged 50 to 64 every five years and saves an estimated 5,000 lives a year by detecting abnormalities of the cervix early and referring women for effective treatment. The purpose of this screening is to reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage. Women of any age, with symptoms, should contact their GP for referral for diagnosis.

However, cervical cancer in women under the age of 25 is very rare with 2.6 cases per 100,000 women. Importantly, younger women often undergo natural and harmless changes in the cervix that screening could identify as cervical abnormalities, and in most cases these abnormalities resolve themselves without any need for intervention.

Cervical cancer is caused by sexually acquired infection with certain types of human papilloma virus (HPV), with two HPV serotypes (16 and 18) causing 70% of cervical cancers and precancerous cervical lesions. The vaccination against HPV, introduced in 2008, is now routinely recommended for all girls aged 12 to 13 years and the first cohort of teenage girls to receive the HPV vaccination in year 8 (those born since September 1996) will turn 23 this year and become eligible for routine screening in two years’ time. The impact the vaccination will have on the number of abnormalities detected through routine cervical screening will be carefully monitored.

Further to the vaccination, in November 2015, the UK NSC recommended that HPV screening should replace the currently used liquid-based cytology test as the primary screening for cervical disease. Evidence shows that using HPV screening as a primary test will be a more effective way of letting women know whether they have any risk of developing cervical cancer. It also means that if the woman tested does not have any evidence of high-risk HPV infection (high-risk HPV is found in 99.7% of cervical cancers), her chances of developing a cancer within five years are very small. This change will be implemented into the NHS Cervical Cancer Screening programme in December 2019.

Despite being vaccinated against HPV, work is ongoing to ensure that uptake of cervical screening remains high with Public Health England running a ‘Be Clear on Cancer’ campaign earlier this year. The campaign was designed to raise the public’s awareness of cervical cancer symptoms; encourage people with those symptoms to go to the doctor; and diagnose cancer at an earlier stage, and therefore make it more treatable, and thereby improve cancer survival rates.

Women with symptoms are encouraged to contact their general practitioner as soon as possible and work is ongoing to ensure that GPs are aware of the symptoms and the need to refer for further investigation. Guidance is available specifically for the primary care of young women who present with gynaecological symptoms and was developed and published in March 2010. The guidance ‘Clinical practice guidelines for the assessment of young women aged 20-24 with abnormal vaginal bleeding’ was produced by a multi-disciplinary group, including professionals, patients and the voluntary sector, and was endorsed by the relevant Royal Colleges. This can be found at this link:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/436924/doh-guidelines-young-women.pdf

Cancer prevention, public health and early diagnosis remain key priorities for this Government. The House debated this issue on 28 January 2019, and during that debate the previous Health Minister, Steve Brine MP, gave reassurance that this Government is not complacent in the fight against cancer.

Department of Health and Social Care.