title: Patients with cervical cancer: why did screening not prevent these cases?
abstract: OBJECTIVE
  The objective of the study was to assess the screening history of women with cervical cancer and review normal cervical smears 5 years preceding the diagnosis.
  
  
  METHODS
  Cytological and histological results of 401 women treated for invasive cervical cancer between 1991 and 2008 at the Radboud University Nijmegen Medical Center were studied. Ninety-eight normal smears were reviewed.
  
  
  RESULTS
  Of the 401 women, 269 (67%) received at least 1 invitation for the national screening program for cervical cancer (NCSP). One- third fell outside the target age of the NCSP. Seventeen percent never responded to the invitation(s). Twenty-one percent had 1 or more normal smears within 5 years preceding the diagnosis. After review, only 39% of those smears were reviewed as a normal smear.
  
  
  CONCLUSIONS
  Half of the women with cervical cancer were never screened because of the limited target age range or nonattendance. Twenty-one percent had a normal smear within 5 years preceding the diagnosis, caused by interpretation and/or sampling errors.
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. r.debie@obgyn.umcn.nl
authors.forename: Roosmarie P
authors.initials: RP
authors.lastname: de Bie
authors.forename: Henke C
authors.initials: HC
authors.lastname: Vergers-Spooren
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
authors.forename: Albertus G
authors.initials: AG
authors.lastname: Siebers
authors.forename: Maria R J
authors.initials: MR
authors.lastname: Salet-van der Pol
authors.forename: Judith E M
authors.initials: JE
authors.lastname: Vedder
authors.forename: Willem J G
authors.initials: WJ
authors.lastname: Melchers
authors.forename: Johan
authors.initials: J
authors.lastname: Bulten
authors.forename: Ruud L M
authors.initials: RL
authors.lastname: Bekkers
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014626:Vaginal Smears