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Three-yearly cervical screening reduces cancer

Three-yearly cervical screening found to reduce the incidence of cervical cancer

New Zealand evidence shows that population based cervical screening is beneficial for the people it is targeted at, National Cervical Screening Programme (NCSP) clinical leader Dr Hazel Lewis said today.

Dr Lewis was commenting in response to a recent article published in the British Medical Journal, Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical abnormality and modelling of cases and deaths prevented.

The article raised issues over the cost effectiveness and benefits of screening programmes in general, and cervical screening in particular.

"Recent New Zealand data published by NCSP shows that with regular three-yearly screening, the chances of developing cervical cancer are reduced from a one in 90 chance to a one in 570," said Dr Hazel Lewis.

"Furthermore, overseas studies reviewed by the NCSP support our findings that when women have cervical smear tests every three years as part of a screening programme, their chance of getting cervical cancer can be reduced by over 90.

The National Health Committee (NHC), whose report Screening to Improve Health in New Zealand: Criteria to assess screening programmes was released this week found "that screening has the potential to prevent the development of disease, prevent premature death and disability and to improve quality of life".

It also noted that screening programmes have associated costs and the potential to cause harm. Because of this inherent risk the NCSP has, at the heart of its operations, the ethical obligation to ensure that the screening programme can deliver the potential benefits and minimise the potential harms.

Dr Lewis said given the history of cervical screening in New Zealand, there is a very high level of public interest in the effectiveness and safety of the NCSP. The Gisborne Inquiry generated some very specific recommendations on changes needed to the operation and ongoing monitoring of the NCSP.

"We acknowledge that there are limitations and risks associated with screening, as well as benefits, and no programme can guarantee 100% effectiveness. This is because screening refers not only to the initial test but also the sequence of events that comprise the screening pathway."

"However, New Zealand's screening programmes are at the forefront in the implementation of quality standards and monitoring in the health sector."

New Zealand women show a strong commitment to the NCSP with more than 90% of eligible women aged 20-69 years enrolled in the programme.

Since the programme began in 1991 there have been significant reductions in both the rates of disease and deaths from cervical cancer. In the 10 years from 1987- 1997 cervical cancer rates dropped by 39%. Over the same period the death rate from cervical cancer dropped by 44%.

To assist women to make informed choices about cervical screening the NCSP publishes up to date information, which is made available to women through their smear takers and the NCSP Website.

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