Invasive cervical cancer in a cytologically screened population

In the community of Malmö, less than 10% of the 20-69-year-old women had been examined cytologically in 1960. By 1970 this figure had increased to 74% and the incidence of invasive cervical cancer decreased by 48% of th incidence prior to cytologic screening. In spite of continued screening and rescreening, no further decrease occurred during the 1970s. In 131 cases, invasive cancer was diagnosed in women previously screened. The smears of 90 of these women had shown changes more than a year before the diagnosis, but 30 women refused examination or therapy. In 60 cases of mild-moderate atypia, further examination consisted solely of a cytologic check-up. We believe that a more active examination program, including colposcopy, in cases of cytologic atypia will be the most important step towards a further reduction in the frequency of invasive cervical cancer.