Estimation of reduction of life-time risk of cervical cancer through one life-time screening.

The purpose of screening for cervical cancer is to prevent the appearance of invasive disease by the detection and treatment of precancerous lesions. Based on data from the developed countries, recommendations have been made regarding the age at which cytology screening should begin and the interval with which rescreening should be performed. However, these recommendations may not be applicable for a developing country like India due to human and financial resource constraints. WHO has recommended that for countries where resources are limited the aim should be to screen every woman at least once in her life-time at an appropriate age. Hence, it is essential to determine the age at which screening may be offered to derive maximum gains. With this in background, based on the data of national cancer registries, an attempt has been made for Indian population to estimate the reduction in the cumulative incidence rate of cervical carcinoma which can be achieved in a cohort of women aged 20-64 years by screening once in her life-time at an appropriate age. Our findings revealed that the first screening offered at 45 years of age could produce gains to the extent of 20-27%, while the screening offered at 50 or 55 years produced the maximum gains to the extent of 25-29%. However, keeping in view the produce years of lives lost in younger women, it may be reasonable to offer once in life-time screening to women aged 45 years.