[Screening for cervical cancer in the county of Funen. Status of 25 years of development and experiences].
BACKGROUND
Since 1979 screening against cervical cancer has been conducted in the County of Funen. In the period 1979-1988 the screening against cervical cancer was opportunistic, where women aged 25-55 years had a PAP-smear taken once a year by their GP or gynaecologists at the hospitals. In this period the coverage was only about 50% and the number of cervical cancer was not decreasing as seen in Counties with organised screening programmes. Since 1989 the screening has been organised in the County of Funen, which will be described in the following, including updating and quality improvements such as implementation of liquid based cytology and semiautomated screening (ThinPrep Imaging System, Cytyc).


METHODS
The programme is based on an automated call-recall system designed to invite women aged 23-59 years. The offer is free of charge and the PAP-smears are taken by the general practitioners. All cervical cytological samples from the County are processed and screened at the Department of Pathology Odense University Hospital. Since 2001 the liquid based technique, ThinPrep-Paptest, has been used, and from 2004 an assisted screening (ThinPrep Imaging System) has been implemented in the routine screening.


RESULTS
Switching from opportunistic to organised screening and implementation of liquid based cytology has resulted in a reduction in the number of samples, about 6,500 per year. The diagnostic quality has increased; the number of incidences of cervical cancer was reduced from 62 in 1988 to 18 in 2004 and the mortality from 29 in 1988 to 12 in 2001.


CONCLUSIONS
Since implementation of the organized screening programme and later of the liquid based cytology the coverage and diagnostic quality have increased. The incidence and mortality of cervical cancer have decreased.
Hølund
Berit
B
Odense Universitetshospital, Afdeling for Klinisk Patologi, og Praksiskonsulentordning for Fyns Amt. berit.hoelund.@ouh.fyns-amt.dk
Grinsted
Per
P
D000328:Adult; D003718:Denmark / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000458:organization & administration* / Q000592:standards; D008875:Middle Aged; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D014626:Vaginal Smears / Q000592:standards