Estimating the efficacy of screening by auditing smear histories of women with and without cervical cancer.
The screening histories of all 348 women with invasive cervical cancer diagnosed in 1992 in 24 self-selected district health authorities and health boards in England, Wales and Scotland were compared with those of 677 age-and residency-matched controls.
The controls were randomly selected from the family health services authority (FHSA) register.
Screening histories, comprising the dates and results of all smears taken before the date of diagnosis of the patient's cancer, were determined from the FHSA computer and laboratory records.
We estimate that the number of cases of cervical cancer in participating districts in 1992 would have been 57% (95% confidence interval 28-86%) greater if there had been no previous screening.
In women under the age of 70 it would have been approximately 75% (31-115%) greater.
Extrapolation of the results from this pilot suggests that screening prevented between 1100 and 3900 cases of invasive cervical cancer in the UK in 1992.
Women with stage 1B cancer or worse were more likely to have no record of previous screening than controls : 47% of these women under the age of 70 had been adequately screened according to current (5 yearly screening) guidelines, compared with 75% of matched controls.
Thirteen per cent of all patients under age 70 had screening histories indicative of inadequate follow-up of smears requiring colposcopy.
The proportion of microinvasive cases with screening predating diagnosis was similar to the proporti...
Mots-clés Pascal : Tumeur maligne, Col utérus, Dépistage, Homme, Programme sanitaire, Prévention, Efficacité, Frottis cervical, Audit, Royaume Uni, Europe, Appareil génital femelle pathologie, Col utérus pathologie, Cytopathologie
Mots-clés Pascal anglais : Malignant tumor, Uterine cervix, Medical screening, Human, Sanitary program, Prevention, Efficiency, Cervical smear, Audit, United Kingdom, Europe, Female genital diseases, Uterine cervix diseases, Cytopathology
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0247157
Code Inist : 002B20C02. Création : 199608.