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.