PATTERNS OF PAP-SMEAR SCREENING IN WOMEN DIAGNOSED WITH INVASIVE CERVICAL-CANCER

The purpose of this study was to gather data about the extent and natu re of the observation that many women with invasive cervical cancer we re reporting a history of regular Pap smears. A retrospective explorat ory/descriptive design was used to examine and characterize the Pap sm ear histories of women with invasive cervical cancer. The study popula tion consisted of women (n = 102) with invasive cervical cancer who at tended the study institution over a 3-year period. Forty-seven percent of 101 evaluable cases had participated in regular Pap smear screenin g, as defined, yet were diagnosed with invasive cervical cancer. Twent y-six percent of women were diagnosed at the time of a routine planned Pap smear, with 64% seeking an appointment because of symptomatology. Forty-four percent had a biopsy at the time of presentation to their physician because of an identifiable lesion, as compared with the sequ ence of abnormal cytology with confirmatory biopsy following. The data were suggestive of the Pap smear being a less sensitive screening too l for adenocarcinoma histology. The Pap smear as a screening tool had made a significant contribution to reducing invasive cervical cancer. However, as currently used, it has not been the complete answer. Resea rch is needed to definitively identify the limitations of the Pap smea r as it pertains to quality control (collection and evaluation) in pra ctice and ability to detect various cervical histologies, in addition to how current and new techniques could be incorporated to maximize di agnosis of preinvasive cervical cancer.