Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

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Matejka Rebolj, Marjolein van Ballegooijen, Elsebeth Lynge, Caspar Looman, Marie-Louise Essink-Bot, Rob Boer, Dik Habbema

OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopathology (PALGA). SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test. MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer. RESULTS: 105 women developed cervical cancer within 2 595,964 woman years at risk after the third negative result at age 30-44 and 42 within 1,278,532 woman years at risk after age 45-54. During follow-up, both age groups had similar levels of screening. After 10 years of follow-up, the cumulative incidence rate of cervical cancer was similar: 41/100,000 (95% confidence interval 33 to 51) in the younger group and 36/100,000 (24 to 52) in the older group (P=0.48). The cumulative incidence rate of cervical intraepithelial neoplasia grade I+ was twice as high in the younger than in the older group (P<0.001). CONCLUSIONS: The risk for cervical cancer after several negative smear results by age 50 is similar to the risk at younger ages. Even after several negative smear results, age is not a good discriminative factor for early cessation of cervical cancer screening.
Original languageEnglish
JournalBMJ. British Medical Journal (International Ed.)
Volume338
Pages (from-to)b1354
ISSN0959-8146
Publication statusPublished - 2009

Bibliographical note

Keywords: Adult; Age Distribution; Aged; Female; Humans; Incidence; Mass Screening; Middle Aged; Netherlands; Prospective Studies; Risk Factors; Uterine Cervical Neoplasms; Vaginal Smears

ID: 13717848