Should Screening Age Be Reduced?

[youngmafbog]

We're very good at turning the NHS into the WHS for all and sundry but that of course means there is not enough left for things like this (more ofteb than not for people who have paid into the service)

Is it about time to adopt 'Charity begins at Home'? I would much rather a young British life was saved than contribute to a dictator or someones space program.

Am I alone in this view?

[youngmafbog]

http://www.dailymail.co.uk/health/article-3452585/Young-mother-told-young-smear-test-dies-cervical-cancer-just-22.html

[bednobs]

While i don't disagree with your point re saving a life Vs foriegn space program, reducing the screening age down is not cost effective on any level.The risk of getting cervical cancer in the age group too low to get screened is very very small, compared to the cost of about 3.5 million extra smear tests just doesn't stack up in any way. Even if we had all the money to do whatever, it still would not be cost effective. Just because you can do something doesn't mean you should.
Also, even if screening had been available for this person, and she took it up, who's to say she would have survived? her first tests were clear (according to the article)

[Peter Pedant]

well said bedkobs and absolutely right !

YMF is asking all the wrong questions with his usual rhyming slang

Now suppose a thousand women are screened and it is expected that one has cervical cancer and the screening test has a false positive rate ( it dings positive when they dont have it ) of 5%.

then fifty have tested positive of which one has the disease
49 will have further testing and anxiety for no benefit

the rate of having the disease whcih was i/1000 or 0.1%
after the screen is now one in fifty or 2%

as you can see we are talking really small numbers

you can also put money on this so you can decided whether you want to screen or perhaps do more hip replacement £5000 a pop with 97% approval rate.

spose a smear costs £30 and further screening £100

one thousand women costs £30k to have a smear
and fifty positives will cost a further £ 5000
which is £35 000 - or seven hip replacements

and you will see that to save one life - in this example - is not the cost of a smear (£30) but more than a thousand times that ( 35k) - but it allows you to make the health care choices

Now YMF [ yeah yeah you often ask me why I write this stuff and I ofter ask myself that as well ] you may ask: " is there a number that if high tells me that a screening test is GOOD and if it is low tells me that it is not much good ? and the answer is YES the PPV ( positive predictive value ) and in our example above it is the figure 2%. This counts as low and tells us the screeninng in this instance isnt much good. You will also see that it is a mix of the prevalence ( 1/1000) and false pos rate.

well done if you have got this far

I have just looked up ce ca in 20-25 y age group
http://www.cancerresearchuk.org/health-professional/cervical-cancer-incidence-statistics#heading-One

and it is 2 per 100 000 - so to pick up 2 in 100 000 you would pay £3m.
I cant be arissed to go thro the whole calculation again.....
even I show signs of fatigue