title: Cervical smear histories of Maori women developing invasive cervical cancer.
abstract: OBJECTIVE
  To locate problems with the implementation of cervical screening for Maori women by investigating the histories of women with invasive cervical cancer, and determining why their disease had not been detected by screening and treated at an intraepithelial stage.
  
  
  METHODS
  In a national study, the screening histories of 46 Maori women with invasive cervical cancer were ascertained by interview and from hospital, general practitioner and cytology laboratory records.
  
  
  RESULTS
  Possible reasons for failure of cervical screening were never having had a smear (54%), infrequent smear tests (22%) and previous abnormal smears without appropriate follow-up (4%). Only six women (13%) had one or more normal smears in the three years before diagnosis.
  
  
  CONCLUSIONS
  The main factor underlying the onset of invasive cancer was an absence of cervical screening or infrequent smear tests. Although no slide review was done, false negative reporting could have been a factor in only a small number of cases. Ways need to be found to encourage Maori women to be screened and to recall women regularly.
authors.affiliation: Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin.
authors.forename: K
authors.initials: K
authors.lastname: Ratima
authors.forename: C
authors.initials: C
authors.lastname: Paul
authors.forename: D C
authors.initials: DC
authors.lastname: Skegg
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening; D008487:Medical History Taking; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009520:New Zealand; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000473:pathology / Q000517:prevention & control*; D014626:Vaginal Smears; D044465:White People