[Compliance in gynecologic screening and causes for delayed tumor diagnosis in East Thüringen]

The public health service of the former GDR paid special attention to early recognition and the registration of malignancies. Due to this efforts the staging of cervical cancer moved to more low-staged tumours admitted to our hospital from the eastthuringian region. In spite of this around 35% of our patients with malignant diseases had stage II or higher staged tumours ad admission. The causes for delayed perception were analysed. Campaign-like preventive actions formerly supported by factories and public health service will not take place again. The responsibility for secondary prevention has to be taken over by practicing gynaecologist in cooperation with the general practitioner. A pilot study revealed that only 11% of the women followed a written invitation for a preventive gynaecological examination. But a general practitioner concerning the patients individuality persuaded 75% of his patients letting perform such a check up. The family doctors direct advice to consult a gynaecologist is the most effective way to get the patients compliance for a preventive examination. The epidemiology and results of therapy will become evident by duty of notification and central registration of malignancies. Relatively centralized therapy and obligatory follow up under the responsibility of the treatment center for about five years enhance the therapeutic results. The positive experience of gynaecological oncology of the eastern part of the Federal Republic of Germany ought to be maintained and should be developed.