title: Cervical smears--an opportunity for disinvestment?
abstract: BACKGROUND
  The National Cervical Screening Programme was introduced to increase population coverage while reducing the overscreening of women at low risk.
  
  
  OBJECTIVE
  To describe the frequency with which cervical smears are unnecessarily repeated within the prescribed screening interval.
  
  
  METHODS
  All cervical smears taken in a primary care setting in Manchester from women aged 20-64, during 1988-92, were identified. A smear was considered unscheduled if it was taken within 30 months of a preceding smear and if there was no clinical indication or laboratory recommendation for an early repeat smear.
  
  
  RESULTS
  A total of 100 134 smears were identified from 85 594 women attending 130 general practices and 40 NHS community clinics; 12 633 women subsequently had 14 702 unscheduled smears; 50% of the unscheduled smears were taken by 18% of the general practices and 8% of the NHS community clinics.
  
  
  CONCLUSIONS
  If they are replicated elsewhere, these findings suggest a substantial disinvestment opportunity.
authors.affiliation: Centre for Cancer Epidemiology, Christie Hospital NHS Trust, Manchester.
authors.forename: M T
authors.initials: MT
authors.lastname: Spence
authors.forename: C
authors.initials: C
authors.lastname: Woodman
authors.forename: S
authors.initials: S
authors.lastname: Collins
authors.forename: B
authors.initials: B
authors.lastname: Donnelly
authors.forename: M
authors.initials: M
authors.lastname: Desai
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D012306:Risk; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics