Dt. Janerich et al., THE SCREENING HISTORIES OF WOMEN WITH INVASIVE CERVICAL-CANCER, CONNECTICUT, American journal of public health, 85(6), 1995, pp. 791-794
Objectives. Each case of a continuous series of invasive cervical canc
er cases was studied with a structured review procedure conducted by a
n expert panel to assess the reason that it was not detected before it
became invasive. Methods. All cases of invasive cervical cancer diagn
osed in a 5-year period among Connecticut residents were identified; a
screening history and screening outcome were obtained for 72% (481 of
664). Results. Two hundred fifty women (51.9%) had suboptimal screeni
ng. One hundred thirty-seven women (28.5%) had never had a screening t
est, and their mean age was greater than that of the rest of the study
population (64.5 years vs 46.5 years). Of the 344 women who had ever
had a Pap test, 113 (32.8%) had their last Pap test 5 or more years be
fore their diagnosis of invasive cancer; 52 (15.1%) were not followed
up properly; 33 (9.6%) had their last smear misread as normal; and 118
(34.3%) developed cervical cancer within 3 years of their last Pap te
st. Conclusions. Physicians, nurses, and other care providers need to
ensure that woman have timely and accurate screening with proper follo
w-up, make increased efforts to reach older women, and improve quality
control of Pap smear readings.