We analysed rates of detection for smear abnormalities in 255000 women served by the Bristol screening programme.
The programme began in 1966 with the aim of eradicating the 30-40 deaths each year in Bristol from cervical cancer.
Organisation has been good and population uptake has been high for the past 15 years.
Records were computerised in 1977.
During the 1988 to 1993 screening round, 225974 women were tested.
New smear abnormalities were found in 15551, of whom nearly 6000 were referred for colposcopy.
These numbers are excessively high in comparison with the incidence of the malignancy we are trying to prevent.
The effect of screening on death rates in Bristol is too small to detect.
Our conclusion is that despite good organisation of the service, much of our effort in Bristol is devoted to limiting the harm done to healthy women and to protecting our staff from litigation as cases of serious disease continue to occur.
The real lesson from 30 years'cervical screening is that no matter how obvious the predicted benefit may seem for any screening test, introduction should never take place without adequate prior evaluation of both positive and negative effects in controlled trials.
Mots-clés Pascal : Frottis, Col utérus, Taux, Détection, Programme sanitaire, Dépistage, Evaluation performance, Angleterre, Col utérus pathologie, Appareil génital femelle pathologie, Tumeur maligne, Grande Bretagne, Royaume Uni, Europe
Mots-clés Pascal anglais : Smear, Uterine cervix, Rate, Detection, Sanitary program, Medical screening, Performance evaluation, England, Uterine cervix diseases, Female genital diseases, Malignant tumor, Great Britain, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0394334
Code Inist : 002B20C02. Création : 01/03/1996.