Patients with cervical cancer: why did screening not prevent these cases?

Am J Obstet Gynecol. 2011 Jul;205(1):64.e1-7. doi: 10.1016/j.ajog.2011.02.046. Epub 2011 Feb 23.

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.

Study design: 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.

Conclusion: 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.

MeSH terms

  • Adult
  • Carcinoma / diagnosis
  • Carcinoma / epidemiology*
  • Carcinoma / prevention & control
  • Diagnostic Errors / statistics & numerical data
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Humans
  • Middle Aged
  • Netherlands / epidemiology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / prevention & control
  • Vaginal Smears