Cervical cancer screening in France

In France, as in other European countries the incidence and mortality rates of carcinoma of the cervix uteri indicate a clear decrease in invasive can cers. Opportunistic screening has spread and, presently, approximately 60% of the female population undergo a regular cytological test. This rate incr eases up to 80% in the younger age groups and decreases to 20% after the ag e of 60 years. In 1990, intervention procedures were defined at a consensus conference; the major recommendations were to screen all women exclusively by cervical smears, for ages 25-65 years over a 3-year period. Guidelines on the quality control of cervical smear taking and reading were published by the national agency of evaluation of health intervention (ANAES). Since 1990, four population-based, organised pilot programmes, have been implemen ted in Isi re. Doubs, Bas-Rhin and Martinique. These programmes evaluate th e participation rate (From approximately 20-80% depending upon the age and the geographical area), the rate of abnormal tests (0.2 3%), according to t he laboratories, the cancer detection rate (0.04%-0.15%) and some other qua lity indicators caters. Recently (November 1998) a law was passed stipulati ng that the screening test will be free of charge when performed in agreeme nt with the national recommendations. A specific organisation for cytologic al quality control will be implemented. An effort to better identify and to include the screening process the women in the population who are not yet participating has to be made. (C) 2000 Elsevier Science Ltd. All rights res erved.