RAPIDLY PROGRESSIVE CERVICAL-CANCER - THE CONNECTICUT EXPERIENCE

A review is presented of 15 years of clinical experience working with women who developed cervical cancer within a short interval after the last reported negative Papanicolaou smear. Our initial report concerne d isolated cases in which women were diagnosed with invasive cervical cancer within 1 year of a reported normal Papanicolaou smear. Our seco nd report focused on a 10-year review of the Yale-New Haven Hospital e xperience, during which 40 of 555 women had rapidly progressive invasi ve disease; 35 cases (87.5%) occurred in women younger than 40 years o ld and almost all of the 40 diagnosed because of persistent symptoms d espite a recent normal Papanicolaou smear. Our final experience is a p opulation-based study of all women in Connecticut who developed cervic al cancer between 1985 and 1990. A total of 118 of 481 (24.5%) partici pants were diagnosed with cervical cancer within 3 years of their last true-negative Papanicolaou smear. Adenocarcinomas occurred in 38 case s (32.2%). These data suggest that rapidly occurring cervical cancer m ay be a manifestation of endocervical carcinomas that have been inadeq uately screened.