PAP SMEAR SCREENING AND CHANGES IN CERVICAL-CANCER MORTALITY IN SWEDEN

OBJECTIVES: Age-adjusted incidence of cervical carcinoma has fallen dr amatically in Sweden in recent decades. This investigation is an attem pt to evaluate the effectiveness of the gynecologic Pap smear screenin g program in terms of reduction of mortality from cervical cancer. MET HODS: Cervical cancer mortality trends in relation to age, calendar pe riod, county and degree of screening activities in the population were analyzed. Multiplicative Poisson regression models were utilized. The reduction of mortality was attributed to the activities of cervical s creening. RESULTS: The analysis gave a calculated 53% reduction in cer vical cancer mortality (95% confidence limits 23-72%), attributable to screening. CONCLUSIONS: The study supports the hypothesis that gyneco logical Pap smear screening has had an important impact on the reducti on in cervical cancer mortality.