title: Does Cervical Screening in Young Women Aged 20-25 Years Lead to Unnecessary and Harmful Interventions?
abstract: BACKGROUND
  Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population.
  
  
  METHODS
  A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study.
  
  
  RESULTS
  During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and- thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases.
  
  
  CONCLUSIONS
  Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).
authors.affiliation: Department of Obstetrics and Gynaecology, Sultan Qaboos University Hospital, Muscat, Oman E-mail : malkalbani@hotmal.com, sarfraz.ahmad@flhosp.org.
authors.forename: Moza
authors.initials: M
authors.lastname: Al-Kalbani
authors.forename: John
authors.initials: J
authors.lastname: Price
authors.forename: Gwen
authors.initials: G
authors.lastname: Thompson
authors.forename: Sarfraz
authors.initials: S
authors.lastname: Ahmad
authors.forename: Hans
authors.initials: H
authors.lastname: Nagar
mesh_terms: D000328:Adult; D003127:Colposcopy; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D009660:Northern Ireland; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery*