Survival from Cervical Cancer Diagnosed Aged 20-29 Years by Age at First Invitation to Screening in England: Population-Based Study

Age at which women are first invited to attend cervical screening in England has changed twice: in 2004, women under 25 years were no longer invited; and in 2012, first invitations were sent six months earlier (at age 24.5 years). Concomitantly, a dramatic increase in screen-detected cervical cancer was observed, and their survival had not been documented. Diagnoses of invasive cervical cancer at ages 20-29 years in 2006-2016 in England were followed until the end of 2018 for deaths. We estimated 8-year overall survival (OS) by International Federation of Gynecology and Obstetrics (FIGO) stage and age at first screening invitation. Overall and relative survival for stage IA cervical cancer for women diagnosed aged 20-29 years in England (n= 1905) was excellent at 99.8% (95% confidence intervals (CI): 99.4-99.9%) and 100% (95% CI: 99.7-100.1%), respectively. OS for stage IB cervical cancer (n= 1101) was 90.4% (95% CI: 88.3-92.2%). Survival from stage IB was worse for women diagnosed age 20-24 years compared to those diagnosed 25-29 years at diagnosis (p< 0.0001), but no difference was observed by age at first invitation for screening,p= 0.8575. OS for stage II (65.5%, 95% CI: 60.2-72.0%) and stage III+ (36.6%, 95% CI 28.4-44.7%) were poorer. Survival from stage I cervical cancer in young women in England is excellent: mortality in women with stage IA cancer is akin to that of the general population regardless of age at first invitation to screening.