Summary. A retrospective longitudinal review identified 341 women who had had a hysterectomy in association with CIN 3, in Tayside Region, during the ycars 1967–1977; 219 (64%) had completed l0 years of cytology follow‐up and of 140 women eligible for 15‐year smears 79 (56%) completed the 15‐year follow‐up. Eight (4%) of the 219 patients developed abnormal cytology, but in six, smears reverted to normal spontaneously. Two patients had persistently abnormal smears and vaginal intraepithelial neoplasia (VAIN) was diagnosed. Only one patient completing 15‐year follow‐up had an abnormal smear and VAIN later diagnosed. No patient over this 15‐year period developed invasive vaginal carcinoma. Sixty vaginal carcinomas were identified during the period 1957–1987 from the gynaecology cancer register; only one was associated with a previous diagnosis of CIN 3 at hysterectomy. With such data we would propose screening 6‐monthly during the first postoperative year and then at 2 years. If these smears were normal, the patient could then revert to the normal screening programme.

A retrospective longitudinal review identified 341 womcn who had had a hysterectomy in association with CIN 3 , in Taysidc Region, during the ycars 1967-1977; 219 (64%) had completed 10 years of cytology follow-up and of 140 women eligible for 15-year smears 79 (56%) complcted the 15-year follow-up. Eight (4%) of the 219 patients developed abnormal cytology, but in six, smears reverted to normal spontaneously. Two patients had persistently abnormal smears and vaginal intraepithelial ncoplasia (VAIN) was diagnosed. Only one patient completing 15-year follow-up had an abnormal smear and VAIN later diagnosed. No patient over this 15-year period developed invasive vaginal carcinoma. Sixty vaginal carcinomas were identified during the period 1957-1987 from the gynaecology cancer register; only one was associated with a previous diagnosis of CTN 3 at hystcrectomy. With such data we would propose screening 6-monthly during the first postoperative year and then at 2 years. If these smears were normal, the patient could then revert to the normal screening programme. 'l'he aim of a successful cervical cytology scrccning programme is to detect and treat prc-invasive cervical intraepithelial neoplasia (CIN), thereby reducing the incidence and mortality of cervical cancer (Duguid ef al. 1985).While CIN is a frequently cncountered lesion, the histologically identical tutnour in the vagina, vaginal intraepithelial neoplasia (VAIN), is rare. It has bccn generally assumed that the natural history of the two conditions may be similar with regard to the possible devclopment of invasive cancer. For this reason any patient undergoing hystercctomy in association with CIN 3 (carcinoma in sitdsevere dysplasia) has traditionally been carefully lollowed with frequent vault smears. Such intensive follow-up

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