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Organization of screening in technically advanced countries: Iceland
IARC Scientific Publications
|January 1, 1986
Summary
Regular cervical cancer screening significantly reduces disease incidence and mortality. However, most invasive cases occur in women with irregular screening attendance or diagnostic/therapeutic failures.
Area of Science:
- Oncology
- Public Health
- Gynecology
Background:
- Mass screening for cervical carcinoma in Iceland between 1964 and 1983 led to a 60% reduction in incidence and mortality.
- Despite screening efforts, challenges remain in preventing all cases of cervical cancer.
Purpose of the Study:
- To analyze the screening histories of invasive cervical cancer cases in Iceland.
- To identify factors contributing to treatment failures and missed diagnoses.
Main Methods:
- Review of screening histories for 77 cases of grossly invasive cervical cancer diagnosed in Iceland over a nine-year period.
- Analysis of tumor characteristics and patient screening compliance.
Main Results:
- 70% of invasive cervical cancers occurred in women with irregular or absent screening attendance.
- 20% of cases represented diagnostic or therapeutic failures despite detected cytological changes.
- 10% of cases involved unusual cancer types that escaped cytological detection.
Conclusions:
- Consistent screening attendance is crucial for cervical cancer prevention.
- Improving public engagement and follow-up reminders are necessary to overcome screening adherence challenges.
- Advancements in sampling techniques and awareness of rarer forms may improve detection rates for the remaining cases.