CampaignsHealthcare RationingCancer Screening & TreatmentWomen still face cervical cancer risk 25 years after treatment Women still face cervical cancer risk 25 years after treatment
28/10/2007
Cancer experts have called for cytological smears to be offered at regular intervals after someone has had severe dysplasia/CIS (Carcinoma in Situ), as recent research has shown that women are still at risk of developing invasive cancer of the cervix or vagina for up to 25 years after being treated for pre-cancerous lesions. The research also found that there was an increasing risk of cervical cancer if the woman was older at the time of diagnosis - with a much higher risk for women aged over 50.
CIS is not cancer but is close to it, as some cells look cancerous - but are lodged superficially in the mucosa (the soft skin-like layer that lines many body cavities such as the nasal and genital passages) and not in any tissue. The research, conducted in Sweden, was based on data from the National Swedish Cancer Register, which included information recorded between 1958 and 2002 on 132,493 women who had a diagnosis of severe dysplasia/CIS.
The observed number of cases of women who developed vaginal cancer was almost seven times higher than expected in women diagnosed with CIS between 1958-1970 compared to a diagnosis in the period 1991-2000 - which could be due to changes in the forms of treatment in different decades.
The authors said: “Although most women with high-grade dysplasia have been protected from invasive cancer, it must be considered a failure by the medical service when women participate in screening, their pre-cancerous lesions are found, they have treatment, participate in follow-up programmes - and then still develop invasive cancer.”
They conclude that follow-up care has, so far, been insufficient and women should be offered cytological smears at regular intervals for at least 25 years after treatment. Long term follow up should not stop for women when they reach the age of 60 if they were older than 35-40 at the time of treatment for CIS.
This view is reiterated in an accompanying British Medical Journal editorial, which suggests that women treated for CIN3 should have long term screening, even if beyond the normal age limit of regular screening.
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