Here are some of the references used in Women’s Hour today.

There was not enough time to discuss the stats properly. What is crucial is the fact that there is a lot of guess work – there has (shockingly) never been a proper RCT of cervical screening in normal risk women. So all estimates involve some guesswork, or modelling. (Archie Cochrane famously said of cervical screening that there has been “never has there been less appeal to evidence and more to opinion”).

Have a look at the 13 minute video on cervical screening http://www.cancerscreening.nhs.uk/cervical/publications/its-your-choice.html (with approx 10 seconds devoted to false positives, less to overtreatment) and compare with the prostate cancer screening decision aid http://www.prosdex.com/index_content.htm.

Men are given numbers, pros and cons, and offered an informed choice – women are given platitudes about yoga, green tea and chocolate cake. The cervical screening leaflets do not spell out the risks of overtreatment and the potential cervical effects and association with preterm birth.

Repeat: I am not against screening per se. I am opposed to unthinking screening, to doctors paternalistically herding women into getting screened, and women being denied and informed and honest choice.

Bristol cervical screening incidence and screening reductions

http://www.bmj.com/content/326/7395/901

Risk factors for cervical screening

http://cancerhelp.cancerresearchuk.org/type/cervical-cancer/about/cervical-cancer-risks-and-causes

Debate on cervical screening

http://www.bmj.com/content/315/7113/953.full

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17260-7/fulltext

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)21007-5/fulltext

Incidence of cervical cancer over time

http://www.ons.gov.uk/ons/rel/cancer-unit/cancer-trends-in-england-and-wales/smps-no–66/index.html (fig 6.7, page 51)

Stats on cervical cancer incidence in the UK

http://info.cancerresearchuk.org/cancerstats/incidence/commoncancers/uk-cancer-incidence-statistics-for-common-cancers

Incidence and mortality of cervical cancer in nordic countries

http://www.biomedcentral.com/1471-2407/11/240/figure/F1?highres=y

http://www.biomedcentral.com/1471-2407/11/240

Incidence cervical cancer in different countries

http://info.cancerresearchuk.org/cancerstats/types/cervix/incidence/