INVOLVING THE GENERAL-PRACTITIONER IN SCREENING FOR CERVICAL-CANCER

In the Leiden region, the cervical cancer screening programme for the age group 35-54 years shifted in 1989 from one in which the smears wer e taken by specially trained paramedical personnel in health centres t o a programme where the general practitioner is the smear taker. Hence , it is possible to compare the results of the two types of screening to evaluate whether involvement of general practitioners leads to bett er uptake of screening. In the 6 year period evaluated in this paper, the 3-yearly cytological rate per thousand for severe dysplasia or wor se increased from 1.00 to 3.40; when stratified by age the positive ra tes were significantly higher. The histological rate per thousand for severe dysplasia increased from 0.60 to 2.09, and for carcinoma in sit u from 0.35 to 1.36. All six invasive carcinomata were detected in the GP programme (0.31%). The general practitioner is clearly more able t o attract the 'high-risk' groups.