Evaluation of German cancer screening by cross-sectional data

Annual cervical cancer screening in the Federal Republic of Germany (FRG) has been free for about 93% of the female population over 29 years old since 1971 (since 1980--over 19 years). In 1978 for women aged 30 to 60 years the participation rate was 45%. Four-fifths of screening examinations are done by office-based gynaecologists, one-fifth by GPs. The evaluation of the limited cross sectional data base shows that the age-standardized risk for cervix cancer or CIS is two thirds less for women with a previous smear in the last year compared with those with a first smear. In a continuously screened population we see a 'comb-out-effect' with rising detection costs per case (between 1976 and 1979 from 26 360 to 33 010 DM in constant prices). This compels against a further annual screening frequency in the FRG.