Prevalence of self-reported cervical cancer screening and impact on cervical cancer mortality in Austria

Pap smear screening was introduced in Austria in the late 1960's and was re commended annually for all women older than 20 years ever since. This is an opportunistic screening, The evaluation has to rely on population based da ta (mortality, stage distribution, screening prevalence). In a representati ve cross-sectional study (women aged 20-69 years, n = 933, conducted in 199 5), 76% reported at least one Pap screening during their life; the highest prevalence (88%) was reported by women aged 50-59 years, the lowest prevale nce (65%) by women aged 60-69 years, Fortyeight per cent of all women repor ted that they had undergone screening at least 4 times (40-49 years: 57%, 2 0-29 years: 34%). Between 1980 and 1996, mortality due to cancer of the uterus, part unspecif ied (ICD-9: 179), decreased by 54% (P = 0.0001) and that of cancer of the c ervix (ICD-9: 180) by 44% (P = 0.0001), Since 1980, age-specific incidence rates of invasive disease decreased (P = 0.0001) in all 10-year age groups (20-29 years: -59%, 30-39 years: -48%, 40-49 years: -34%, 50-59 years: -62% , 60-69 years: -59%). The incidence of preinvasive disease increased signif icantly (P = 0.001) in the age groups 20-29 years by 30% and 30-39 years by 45%, respectively. No significant changes are observed in other age groups . Opportunistic screening has reduced mortality from cervical cancer and pa rticularly limited the increase among younger women, but the high proportio n of cancer deaths from uterine cancer, in part unspecified, obscures the a ctual trend. We estimate that the true mortality from cervical cancer has b een nearly halved between 1980 and 1996. Most of this reduction must be att ributed to the screening activities in the 1970's and we expect a further d ecrease as a result of the expanded screening activities in the 1980's.