Reflections on a cytology screening service

A review of the results of the examination of gynaecological material undertaken during one year by an established cytology laboratory taking part in the Population Screening Service for Carcinoma of the Cervix in the United Kingdom is presented. The overall positive rate was 5/1,000 and for first examinations was 9.4/1,000. Only a relatively small proportion of the female population was screened but this included a wider spread over the social classes and a greater number of younger women, in whom the disease is becoming more common. In view of the failure to involve all women in a comprehensive screening programme, it is considered advisable to concentrate on those women who are particularly at risk and to take advantage of their attending family planning, ante-natal and veneral disease clinics where cervical smears can be taken, even if they are below the age of 35 years at which the screening programme usually starts. Training in cytology for doctors and nurses working in the clinics is essential and the availability of a special cytology clinic to assist in the diagnosis of difficult cases is very valuable.