Background. Cervical cancer is an important cause of death throughout
the world, especially in less developed countries. Reports of trends i
n cervical cancer mortality from less developed countries have been li
mited by poor data quality and inaccurate population estimates. This p
aper examines trends in cervical cancer mortality in South Africa from
1949 to 1990 and discusses the impact of cytology screening on these
trends. Method. Analysis of national mortality statistics and reconstr
ucted population data. Results. The age-standardized mortality rates f
or Whites declined after the mid 1960s, while that for coloureds rose,
particularly before the 1970s. These trends were affected predominant
ly by trends among women in the 35-64 age range. Conclusion. The patte
rn of mortality in successive birth cohorts for Whites is consistent w
ith a reduction in age-specific mortality following the advent of cyto
logical screening. The same pattern is not evident in trends for Colou
reds, among whom screening has apparently had a minor impact if any at
all. The apparent lack of impact of screening in those groups of wome
n most at risk of cervical cancer lends weight to demands for the Impl
ementation of equitable and rational screening programmes for cervical
cancer in South Africa and internationally.