The incidence of deaths from cervical cancer in women 20 to 34 years old increased threefold in the United Kingdom from the 1960s to the 1980s. In 1988, the UK instituted a national screening program that provided free Pap smears to all women between the ages of 25 and 64 every three to five years. Recent reports have criticized the program, saying its costs do not outweigh the benefits. Now, researchers from the London School of Hygiene and Tropical Medicine have taken a look at the national statistics and come up with their own conclusions about the cervical cancer screening program.

What the researchers wanted to know: How many deaths from cervical cancer have been prevented by the national screening program, and does the number justify its cost?

What they did: The researchers used statistics published by the government on the number of deaths from cervical cancer in England and Wales. They split the data into sets of five years beginning in 1953–1957 and ending in 1983–1987, when the national screening program started. Based on these numbers, they estimated the death rates that would have occurred if no screening program had been put in place. They also got data on cervical cancer deaths from other countries, to compare death rates in the UK with those in other nations.

What they found: The death rate from cervical cancer for women born around 1955 was higher than in any other European country in 1988 and would have been the highest in the world in 2003 without the implementation of screening, the authors estimate. About 1 in 65 women younger than 50, they say, would die before her 85th birthday from cervical cancer without the national screening program—even given widespread optional screening. They say that screening costs the country about 150 million pounds (about $269,000,000) per year, or 36,000 pounds (about $64,000) per life saved. The authors call the program "remarkably successful."

What it means to you: National screening programs like the one in the UK can be an effective way to target a growing health problem. The United States does not currently have a similar national screening program, though women are routinely screened when they go to the doctor for a physical. For the individual, this study is a reminder that routine screening, even once every three to five years, can substantially reduce your risk of death from cervical cancer.

Caveats: This study relied on a lot of estimation and assumptions. For example, it assumed that women born after 1952 had the same sexual habits as those born in 1952, which is not true. However, the authors tended to be conservative in their guesses about the number of deaths from cervical cancer so they would not overstate the effect of screening.

Find out more: If you want to know about the UK's screening program the website is www.cancerscreening.nhs.uk

For more general information about cervical cancer risks, prevention, and screening, try the National Cancer Institute's website.

Read the article: Peto. J. et al. "The Cervical Cancer Epidemic That Screening Has Prevented in the UK." The Lancet. July 17, 2004, Vol. 364, No. 9430, pp.249–256.

Full text online: www.thelancet.com (You will have to complete a free registration to get it.)