Screening history of women in Malmö with invasive cervical cancer.
OBJECTIVE
Cervical cancer is one of the most common forms of cancer among women. Cytological screening and follow-up are potentially effective procedures for preventing the development of - and mortality from - cervical cancer. The purpose of this study was to investigate the screening history of women diagnosed with cervical cancer with the aim of improving the screening programme.


METHODS
All of the 187 women diagnosed with invasive cervical cancer in Malmö between 1991 and 2000 were identified, and those below 61 years of age (n=130) were included in the analysis. The cytological and histological screening history of these women prior to their diagnosis was scrutinized. We analyzed shortcomings related to the cervical screening with special attention to participation defined as having had a cervical smear within 1 year of the scheduled time.


RESULTS
Of the non-participants who developed cervical cancer (n=70), roughly one-third "never participated," half were "sub-optimal participants," and one-sixth were "decliners," i.e., women who declined the recommended measures. Among participants (n=60), 80% were either "unexplained" (n=35) or "misread as normal" (n=13). The 9.5% subgroup of non-participants was at an 11-fold increased risk of being diagnosed with invasive cervical cancer.


CONCLUSIONS
The greatest reduction in cervical cancer would be realized if non-participants could be brought into the screening program.
Lindqvist
Pelle G
PG
Department of Obstetrics and Gynaecology, Clinical Science Malmö, University Hospital MAS, Lund University, Ingång 74, Se-205 02 Malmö, Sweden. pelle.lindqvist@med.lu.se
Hellsten
Charlotte
C
Rippe
Amanda
A
D000328:Adult; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000639:trends*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D014626:Vaginal Smears