Towards effective cervical screening.
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Biomedical subjects
Publications and source records attributed to C Havelock.
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Examination was made of the cervical cytology in 107 patients who underwent cone biopsy with a subsequent diagnosis of severe dysplasia or carcinoma in situ (105) or microinvasive carcinoma (2). Multiple smears had been performed for each patient over a period of time. From the total number of smears a 'false-negative' cervical cytology rate of 10.3 per cent was found. The time interval from the initial abnormal smear until definitive surgical treatment was carried out was calculated. The cervical smear prior to cone biopsy was found to correlate with the histological diagnosis in only 46.7 per cent. The implications of performing repeated cervical cytology are discussed and a firm recommendation is made that patients with abnormal cervical smear be promptly referred to definitive treatment.
Well organized cervical screening in general practice can have considerable clinical and financial rewards. Yet in a randomized survey of general practitioners in the United Kingdom only 43% operated a system for cervical screening which allows previously untested women to be identified and invited for testing.A younger age of general practitioner, a more rural practice, a larger practice size, employment of a practice nurse, a belief in the effectiveness of cervical screening and a positive view of the time spent on screening were all strong predictors of an organized approach to cervical screening within a practice. Being female or having a female partner was not statistically associated with systematic screening. The results demonstrate a need for education within general practice which emphasizes the relevance and significance of cervical screening and the essential contribution that can be made by each individual general practitioner to the success of the whole cervical screening programme.