Cervical cancers in a high-risk population with a screening program

January 01, 0001

Cervical cancers in a high-risk population with a screening program

These UK authors investigated why invasive cervical cancers developed in a high-risk urban population with an established screening programme in an observational study. They analyzed the screening histories of women with invasive cancer according to route to diagnosis, histological type and International Federation of Obstetrics and Gynecology (FIGO) stage.

They found: "There were 133 invasive cancers, 53 CGIN, 1502 CIN3 and 1472 CIN2. Screen-detected cancers in asymptomatic women comprised 48.9% of cancers and were successively more likely to be in younger age groups; all except one were stage IA or IB1. Screen-detected IA cancers were more likely to be in women screened within 0.5-5.0 years (80.5%) than screen-detected fully invasive (58.3%) or symptomatic cancers (35.3%). Seventy-one (53.4%) women had been screened within 0.5-5.0 years; 11 had negative cytology within 0.5-3.5 years and two tests within 10 years. The other 60 had negative tests less frequently or had previous abnormal cytology, colposcopy or treatment. Potentially avoidable factors were often multiple, including false-negative cytology, high-grade cytology reported as low-grade and lapses in attendance either for routine or repeat screening, or for colposcopy or treatment."

The authors concluded: "While often potentially avoidable, cancers in previously screened women tended to be early stage, detected by cytology and rare when compared with high-grade CIN."

Screening programs are very good, but not foolproof.

For the full abstract, click here.

BJOG 117(6):736-745, May 2010
© 2010 to RCOG
Invasive cervical cancer audit: why cancers developed in a high-risk population with an organised screening programme. A Herbert, Anshu, G Culora, et al. Correspondence to Dr. Herbert: [email protected]

Category: X. Female Genital System, Breast. Keywords: cervical cancer, audit, cervical intraepithelial neoplasia, interval cancer, invasive cervical cancer, screen-detected cancer, observational study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 27 April 2010

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