Long-term mass screening in uterine cervical carcinoma eradication strategy

Results of the Tochigi Cancer Detection Center screening of a total of 252,453 women for uterine cervical neoplasm, conducted over fifteen years, are reported. Among the women, 16,454 (6.5%) were referred for precision reexamination and 14,129 (85.9%) responded. Eighty-nine patients with unmistakably invasive carcinomas at International Federation of Gynecology and Obstetrics (FIGO) Stage Ib or more, 81 with microinvasive carcinomas at Stage Ia and 192 with carcinomas in situ were found, all of them receiving appropriate treatment. The cervical neoplasm detection rate decreased from 26.2 per 10,000 to 6.9 per 10,000 during the 15 years (average rate, 0.15%) with a relatively increasing trend of early stage carcinoma (microinvasive and in situ carcinomas) (62.9-84.0%) over frank carcinoma (37.1-16.0%). During the same period, the ratio of the uterine carcinoma mortality rate to that of all carcinomas decreased from 5.0 to 2.7%. The mean ages (years) of patients with frankly invasive (53.4), microinvasive (48.2) and in situ (45.6) carcinomas, however, remained constant over the 15 years. Five-year actuarial survival rates were 86.6% for frank, 98.8% for microinvasive and 98.8% for in situ carcinomas. Among rechecked women, all frank carcinoma patients were rescreened after more than one-and-a-half years of their last check. These results suggest that long-term mass screening and yearly checks would be of value both for detecting uterine carcinoma earlier and for reducing its mortality rate.