S. Ciatto et al., SCREENING HISTORY OF INCIDENT CASES OF INVASIVE-CARCINOMA OF THE CERVIX - FLORENCE DISTRICT 1988-1989, Tumori, 79(5), 1993, pp. 311-313
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.