title: Analysis of 13 million individual patient records pertaining to Pap smears, colposcopies, biopsies and surgery on the uterine cervix (Belgium, 1996-2000).
abstract: OBJECTIVE
  Cervical cancer screening by surveys overestimate coverage because of selection and reporting biases.
  
  
  METHODS
  The prepared Inter-Mutualistic Agency dataset has about 13 million records from Pap smears, colposcopies, cervical biopsies and surgery, performed in Belgium between 1996 and 2000. Cervical cancer screening coverage was defined as the proportion of the target population (women of 25-64 years) that has had a Pap smear taken within the last 3 years. Proportions and incidence rates were computed using official population data of the corresponding age group, area and calendar year.
  
  
  RESULTS
  Cervical cancer screening coverage, in the period 1998-2000, was 59% at national level, for the target age group 25-64 years. Differences were small between the 3 regions. Variation ranged from 39% to 71%. Coverage was 64% for 25-29 year old women, 67% for those aged 30-39 years, 56% for those aged 50-54. The modal screening interval was 1 year. In the 3-year period 1998-2000, 3 million smears were taken from the 2.7 million women in the age group 25-64. Only 1.6 million women of the target group got one or more smears in that period and 1.1 million women had no smears, corresponding to an average of 1.88 smears per woman.
  
  
  CONCLUSIONS
  Coverage reached only 59%, but the number of smears used was sufficient to cover more than 100% of the target population. Structural reduction of overuse and extension of coverage is warranted.
authors.affiliation: Belgian Cancer Center/Unit of Cancer Epidemiology, Scientific Institute of Public Health, J. Wytsman Street 14, Brussels, Belgium. marc.arbyn@iph.fgov.be
authors.forename: Marc
authors.initials: M
authors.lastname: Arbyn
authors.forename: Cindy
authors.initials: C
authors.lastname: Simoens
authors.forename: Herman
authors.initials: H
authors.lastname: Van Oyen
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Foidart
authors.forename: Frédéric
authors.initials: F
authors.lastname: Goffin
authors.forename: Philippe
authors.initials: P
authors.lastname: Simon
authors.forename: Valérie
authors.initials: V
authors.lastname: Fabri
mesh_terms: D000328:Adult; D001530:Belgium; D001706:Biopsy / Q000706:statistics & numerical data*; D003127:Colposcopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D065006:Papanicolaou Test; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014626:Vaginal Smears / Q000706:statistics & numerical data*