The screening histories of women with invasive cervical cancer, Connecticut

Each case of a continuous series of invasive cervical cancer cases was studied with a structured review procedure conducted by an expert panel to assess the reason that it was not detected before it became invasive. All cases of invasive cervical cancer diagnosed in a 5-year period among Connecticut...

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Bibliographic Details
Published in:American journal of public health (1971) 1995-06, Vol.85 (6), p.791-794
Main Authors: Janerich, D T, Hadjimichael, O, Schwartz, P E, Lowell, D M, Meigs, J W, Merino, M J, Flannery, J T, Polednak, A P
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnosis
Biological and medical sciences
Carcinoma, Adenosquamous - diagnosis
Carcinoma, Squamous Cell - diagnosis
Cellular biology
Cervical cancer
Cervix
Connecticut
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Laboratories
Medical sciences
Medical screening
Middle Aged
Non tumoral diseases
Pap smear
Papanicolaou Test
Patients
Physicians
Public health
Screening
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - pathology
Vaginal Smears
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Summary:Each case of a continuous series of invasive cervical cancer cases was studied with a structured review procedure conducted by an expert panel to assess the reason that it was not detected before it became invasive. All cases of invasive cervical cancer diagnosed in a 5-year period among Connecticut residents were identified; a screening history and screening outcome were obtained for 72% (481 of 664). Two hundred fifty women (51.9%) had suboptimal screening. One hundred thirty-seven women (28.5%) had never had a screening test, and their mean age was greater than that of the rest of the study population (64.5 years vs 46.5 years). Of the 344 women who had ever had a Pap test, 113 (32.8%) had their last Pap test 5 or more years before their diagnosis of invasive cancer; 52 (15.1%) were not followed up properly; 33 (9.6%) had their last smear misread as normal; and 118 (34.3%) developed cervical cancer within 3 years of their last Pap test. Physicians, nurses, and other care providers need to ensure that woman have timely and accurate screening with proper follow-up, make increased efforts to reach older women, and improve quality control of Pap smear readings.
ISSN:0090-0036
1541-0048
DOI:10.2105/AJPH.85.6.791