Source: Radio New Zealand, 14 September 2016
The Ministry of Health is raising the age at which women begin
having cervical smear tests from 20 to 25.
The change will take effect in 2018.
virus which causes 90 percent of cervical cancers is said to be
common in younger age groups.Photo: GARO / Phanie
The ministry said there was now a strong body of evidence that
screening women between the ages of 20 and 24 did more harm than
National Screening Unit clinical director Jane O'Hallahan said
the main reason was that the human papillomavirus (HPV), which
caused more than 90 percent of cervical cancers, was common in
younger age groups and typically cleared up on its own.
She said screening of that age group raised the stress and
anxiety associated with additional tests, treatments and
"International and New Zealand experience also shows that
screening women aged 20 to 24 does not reduce cervical cancer
"Since the inception of the National Cervical Screening
Programme in 1990, there has been no reduction in cervical cancer
incidence rates or mortality for those aged 20 to 24. In contrast,
there's been a marked and gradual reduction in cervical cancer
rates in older age groups," Dr O'Hallahan said.
The age change is in line with that of many other countries,
including Australia, England, Scotland, the Netherlands and
The World Health Organisation's International Agency for
Research on Cancer also recommends cervical screening begin at age
"The HPV vaccination programme in schools offers the best
protection to younger age groups from HPV infections and invasive
cancer. There will be accelerated progress with the programme's
coverage rates with boys also being offered the vaccination from
"We recognise that there are rare cases of younger women
developing cervical cancer, however the evidence shows this is
usually aggressive forms of cancer which screening would not have
protected them from."
Dr O'Hallahan said if someone outside the age group for
screening noticed any symptoms, such as unusual bleeding, discharge
or pain, they should seek medical attention promptly.
Concern that younger girls will be caught out
The Federation of Women's Health Councils said it disagreed with
the plans to raise the age.
Its co-convenor, Barbara Holland, said some young women needing
further testing or treatment could miss out.
"We originally supported primary HPV screening for all women,
but we have since seen statistics on the number of high-grade
lesions for the under-25 cohort, and we believe they should have a
different testing process at this stage", Ms Holland said.
"They should have their cells tested at cytology as well as the
primary HPV test."
Ms Holland said there were concerns about the modelling
conducted for the new testing regime and warned against the
"We understand the modelling was done on overseas people and
that it was done on the basis of looking at other programmes that
don't use the automated, sophisticated cytology [cell] testing that
"The number of non-HPV-related atypical presentations will not
be captured under the new primary testing focus," she said.
But Family Planning has praised the decision to raise the
Family Planning national medical advisor Christine Roke said the
announcement was great news.
Dr Roke said international evidence showed that screening before
the age of 25 did not make any difference to the mortality rate for
women who have developed cervical cancer.
Once a young women under 25 acquired the HP virus most were able
to get rid of it if they had a good immune system over the next few
years without it causing any harm at all, said Dr Roke.