Women continue to be at risk of developing invasive cancer of the cervix or vagina twenty-five years after being treated for pre-cancerous lesions, reports the British Medical Journal. Cancer experts are now calling for cytological smears to be offered at regular intervals for at least 25 years after a woman has had carcinoma in situ (CIS). The study, by researchers in Sweden, noted that while CIS cells look cancerous, they are superficially in the mucosa and not in any tissue. Women with such a diagnosis are more than twice as likely to develop cancer as the general female population. They also found that there was an increasing risk of cervical cancer if the woman was older at the time of diagnosis, with a much higher risk for women aged over 50.
The risk also grew as the decades went by. Women were twice as likely to develop invasive cervical cancer after diagnosis of CIS if that diagnosis was made in the period 1991-2000 as in the period 1958-1970. This could be due to changes in the forms of treatment in different decades. The observed number of cases of women who developed vaginal cancer was almost seven times higher than expected
"Although most women with high-grade dysplasia have been protected from invasive cancer it must be considered a failure of the medical service when women participate in screening, their pre-cancerous lesions are found and they subject themselves to treatment of those lesions, presumably participate in follow-up programs and still develop invasive cancer," lamented the researchers. They conclude that follow-up care has, so far, been insufficient and women should be offered cytological smears at regular intervals for at least 25 years after treatment.
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Source: British Medical Journal
