Table 3.

Recommendations for health care practitioners to address with patients concerned about deintensification of screening programs

Change in screening program	Recommended information
Changing screening intervals	Some cancers can be very slow growing, taking between 5 and 10 years before growing to a point of causing a problem for a person’s health and so in some cases, might not cause any problems in a person’s lifetime. For example, human papillomavirus (HPV) is the main cause of cervical cancer, which is a very common infection where most sexually active people will pick up HPV at some point in their lives. In cervical cancer, only a small number of people who get HPV go on to develop abnormal cells and an even smaller number go on to develop cancer. Persistent infection with a cancer-causing type of HPV can cause abnormal cell changes that may lead to cervical cancer. However, this usually takes a long time, often more than 10 years. As tests that we use for cancer screening are now more accurate and sensitive, we can trust the results from these for a longer period of time. This means that if you are found to be at low risk, you do not need to be tested as frequently and can be more confident in the test results.
Reducing age range for screening	Cancer does not affect every age group the same. We now have extensive data about the number of cases of different cancers across the population and so we know which age groups are most at risk and would benefit most from screening. In some cancers, there can be more harm than benefit to screening younger age groups, as some abnormalities may be detected which would otherwise go away by themselves, or not cause harm in that person’s lifetime, but may lead to unnecessary treatment.
Changing screening technology	Owing to advancing technology, new tests are being developed which are more accurate and sensitive than previous tests. Some tests, such as the new cervical screening test, are also detecting changes at an earlier stage than the previous tests and will pick up any abnormal changes a stage earlier. The new cervical screening test is detecting HPV types which have the potential to cause cancer and the persistence of these HPV types, therefore detecting the virus that causes most cervical cancers.