Why young women should be screened for cervical cancer: the distinction between CIN2 and CIN3.

摘要

We write in response to Sasieni et al. who refer to our article on the benefit of screening young women. We accept that their calculations (based on modeling) may be more or less correct in saying that "only" 3% of CIN3 would become invasive by age 25 years. During 2003, before implementing the policy of not inviting women aged 20-24 years for screening, 4,000 cases of CIN3 were registered in England in that age band. Those 120 women [3%] might disagree that screening was unnecessary. Furthermore, not all women are screened as soon as they reach age 25 years. Treating high-grade CIN is essentially a treatment of risk and reduces the likelihood of invasive cancer developing in subsequent years of life-after an unknown interval for any individual woman. We quoted the evidence of Peto et al. that at least 50% of CIN3 would eventually become invasive later in life.