title: Dramatic increase in cervical cancer registrations in young women in 2009 in England unlikely to be due to the new policy not to screen women aged 20-24.
abstract: OBJECTIVE
  To explore whether the 17% increase in cervical cancer in England in 2009 was due to the change in cervical screening policy.
  
  
  METHODS
  Trends in incidence of cervical cancer and of cervical intraepithelial neoplasia grade 3 (CIN3) were analysed for England, Wales and Scotland. Invasive cervical cancer data on 4079 cancers in women aged 20-39 diagnosed between April 2007 and August 2011 in England were analysed by single year of age.
  
  
  RESULTS
  In England there was a 38% (95% confidence intervals [CI] 18-62%) increase in cervical cancer incidence rates in women aged 25-29 in 2009 relative to 2008, and a 30% (11-51%) increase in women aged 35-39. Compared rates in 2010 are similar to those in 2008. The average increase between 2000 and 2010 in women aged 25-29 was no greater in England than in Scotland and Wales (relative risk 0.98, 95% CI 0.69-1.39). In England there has been a gradual increase in CIN3 (particularly for ages 25-29) since 2003, with a more dramatic increase in 2009, but a fall in 2010. Audit data showed an increase in cancers diagnosed at age 25 in 2009/2010 and 2010/2011 (P ≤ 0.0004). No increase was observed at age 26. For ages 27-29 an increase in cancer was observed for 2008/2009-2009/2010 when compared with 2007/2008-2010/2011 (P < 0.00001), but linear trends were not significant.
  
  
  CONCLUSIONS
  The increase in cervical cancer in England in 2009 cannot be attributed to the lack of screening of women aged 20-24, or to a general decrease in the coverage or quality of cervical screening.
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK. p.sasieni@qmul.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Sasieni
authors.forename: Alejandra
authors.initials: A
authors.lastname: Castanon
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods*; D004739:England; D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D012042:Registries; D012306:Risk; D012606:Scotland; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D014852:Wales; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology