Review of an Irish cervical smear service

Cervical cytology material from 5,815 women who presented to General Practitioners throughout Ireland for routine cervical smears were referred to our Pathology Laboratory. The smears were reviewed retrospectively in order to report on the incidence of dyskaryosis and other abnormalities diagnosed on cervical cytology. Evidence of dyskaryosis was found in a total of 2.2% and "borderline" changes in a total of 0.3% of smears. Cytology and subsequent histology were compared in cases of significant cervical intraepithelial neoplasia. Comparison in cases of moderate and severe dyskaryosis showed precise correlation between the diagnosis of cervical intraepithelial neoplasia on biopsy and its prediction on cytology in 30 of 33 cases. Over a third of women screened were in their 4th decade and the highest incidence of dyskaryosis was in this age group. Only 10% of those screened were 50 years or over and a third were aged 40 years and over. These facts are of relevance with regard to the problem of targeting the population at risk in the long term planning of routine cytology screening services in this country.