SCREENING HISTORY OF INCIDENT CASES OF INVASIVE-CARCINOMA OF THE CERVIX - FLORENCE DISTRICT 1988-1989

Background: Incident cases of carcinoma of the cervix may be assumed a s failures of a population-based cytologic screening program. Monitori ng such cases would provide an estimate of screening effectiveness, an d evaluating the causes of the failures would improve screening perfor mance. Study design: All incident cases of cervicocarcinoma registered in 1988 and 1989 in the Tuscany Tumor Registry were eligible for the study and were reviewed. Results: Sixty-nine eligible cases were consi dered. Non- or irregular attendance (negative smear-to-diagnosis inter val >5 years) for the Pap smear was recorded in 53 subjects. A false-n egative smear (smear-to-diagnosis interval <5 years) and refused or in adequate assessment/treatment at private practices or local hospitals were recorded in 12 cases. False-negative smears by the local screenin g program were recorded in 4 cases only. Conclusions: Non- or irregula r attendance was the major cause of screening failures. Since cytologi c screening or diagnostic assessment outside the screening program may be inadequate, central screening and follow-up is recommended. Non-at tenders showed a strong negative attitude towards screening, and gener al practitioners and gynecologists need to be further stimulated for s ystematic screening promotion. Immediate evaluation of the screening h istory of incident cases of cervicocarcinoma should be mandatory in an y screening program.