While cervical cancer screening has proven very effective in decreasing the incidence of pre-cancer and cervical cancer, like any screening test, it isn’t perfect. Women should be aware of the benefits and harms of cervical cancer screening and make an informed decision to screen.
- Screening where practiced effectively has resulted in decreased cervical cancer incidence and mortality in women.
- Cervical cancer is one of the most preventable cancers. Cervical cancer begins as an infection of the uterine cervix with high-risk human papillomavirus (hr-HPV) that needs to persist for many years. The transition from initial HPV infection to invasive cancer seems to take decades in most cases, with a minimal latency period of approximately 7 years.
- Cervical cancer screening saves lives. Most cervical cancer cases occur among women who have not undergone screening or who have had a long interval between Pap tests. In BC, about 58% of the 178 patients diagnosed with invasive cervical cancer in 2014 were five years or more overdue for screening. The majority of cases are diagnosed in the 30-39 and 40-49 age groups.
- Women between the ages of 25-69 stand to benefit the most from screening
- Most HPV infections and pre-cancerous lesions resolve spontaneously, particularly among younger women who are of childbearing age.
- Over-diagnosis and treatment of these transient cervical intraepithelial neoplasia (CIN) are associated with substantial harms, including heightened psychosocial consequences in the women treated, increased risk of pre-term and low-birth-weight babies (especially for women treated with excisional approaches), and unnecessary utilization of health care resources.
- A 2008 study concluded that in the treatment of CIN, all excisional procedures seem to be associated with adverse obstetric morbidity, but among these, only cold knife conization is associated with a significantly increased rate of severe outcomes.
- Initiating screening in women under 25 can produce more harm than benefit, as cervical cancer is not common in women under age 25.