Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire.

Paterson, M. E. L.; Peel, K. R.; Joslin, C. A.

doi:10.1136/bmj.289.6449.896

Cited by 110 publications

(57 citation statements)

References 18 publications

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“…This has been linked largely to good population coverage (Boyes et al 1961, MacGregor et al 1985. Moreover, it is argued that a high proportion of women with cervical cancer have never had a smear test (Paterson et al 1982), and further, that women who are screened have a low incidence of cervical cancer (Chamberlain 1984). Consequently, General Practice in the NHS: the 1990 Contract (DoH 1989) recommended that women aged between 20 and 60 in Scotland (20 and 64 in England and Wales) should be offered cervical cytology, and established requirements within general practice to incorporate screening targets for cervical disease, linked to remuneration.…”

Section: Prevention Discourse and Cervical Screeningmentioning

confidence: 99%

Cervical screening, compliance and moral obligation

Howson

1999

Sociology Health & Illness

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Cervical screening has been subject to extensive scrutiny within the social sciences over the last two decades. Moreover, it has been described, in passing, as an example of 'surveillance medicine' through which new aspects of people's lives are brought under medical scrutiny. Cervical screening is an example of secondary prevention with which women, on the whole, are expected and encouraged to comply, in what are deemed to be their best interests. However, the social science literature on cervical screening tends to present compliance as a morally neutral and unproblematic response to information about disease prevention. In contrast, this paper seeks to illustrate how women draw on specific contexts and relationships through which participation in, or compliance with screening, is given meaning. Drawing on women's accounts of their experience of screening participation, the paper suggests that compliance with cervical screening cannot be viewed exclusively as a morally neutral, if desirable, outcome of disease prevention initiatives, but may also be embedded within a moral framework of selfresponsibility and social obligation.

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Section: Prevention Discourse and Cervical Screeningmentioning

confidence: 99%

Cervical screening, compliance and moral obligation

Howson

1999

Sociology Health & Illness

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“…There was less variation between the smears from cases and from controls in the percentages of unsatisfactory, which varied between 13-25% among smears from cases and 15-29% among smears from controls. (Mitchell et al, 1988) to 64% (Attwood et al, 1985) previously reported in the predominantly small series of patients with invasive cervical cancer for whom the previous negative smears have been reviewed (Rylander, 1977;Gad & Koch, 1978;Berkowitz et al, 1979;Berkeley et al, 1980;Holman et al, 1981;Morell et al, 1982;Walker et al, 1983: Paterson et al, 1984Gay et al, 1985;Attwood et al, 1985;Graff et al, 1987;Mitchell et al, 1988;Mitchell et al, 1990).…”

mentioning

confidence: 99%

Smear misclassification in a cervical cancer screening programme

Lynge

Arffmann²,

Poll³

et al. 1993

Br J Cancer

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Summary A nested case-control study was undertaken in the Maribo County cohort of 27,811 women with negative Pap smears. Sixty women who later developed invasive cervical cancer constituted the cases, and five matched controls were selected from the cohort for each case. A total of 633 previous, negative smears for the cases and controls were reviewed independently by two pathologists. The review showed misclassification to be frequent in these smears collected in the period 1966-82. Thirty-five smears were considered positive at the review. The misclassification was differential in respect to the women's later disease status. The odds ratio for patients compared with controls for having at least one positive smear was 22.12 Materials and methods CohortIn the cohort study all smears taken in the Maribo County in the years 1966-1982 among women born 1918-1952 were registered. Both smears taken within the organised screening programme and all other smears taken as part of the clinical work by general practitioners, private gynaecologists, and hospital wards were included.All women with at least one smear were followed up for death and emigration in the Central Population Register, for cases of invasive cervical cancer in the computerised files of the local department of pathology and in the Danish Cancer Register, and for operations causing surgical removal of the cervix uteri in the Danish Hospital Discharge Register and in questionnaire data collected at the screening rounds. A cohort was thus identified of 27,811 women, who originally had negative smears. CasesA total of 60 cases of invasive cervical cancer was registered in this cohort when the follow-up was extended to include 1984. These 60 women constitute the cases. ControlsFor each case, five women were selected as controls from the cohort. Those five women were selected, who came closest to the case in date of birth, had the first negative smear in the same year as the case, had the same number of negative smears, had not developed a precancerous lesion of the cervix uteri, and had been followed up with the cervix uteri intact for at least the same time interval since the last negative smear as the case.Histology review Slides from the paraffin blocks based on which the original diagnoses were made were reviewed by two pathologists (EA and PP). Only those cases for which invasive growth was confirmed at the review remained as cases in the further analysis.Cytology review All previous negative smears for cases and controls were reviewed blindly by two pathologists (EA and PP). Slides with dots from the cytotechnicians' original evaluation were registered, and the dots were removed with ethanol before the review. Smears were classified as being satisfactory or unsatisfactory for evaluation of CIN. A satisfactory smearCorrespondence: E. Lynge.

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“…[13][14][15][16] Nevertheless, cervical cancer screening programmes occasionally encounter women with ICC that have followed the screening guidelines after a normal or a mild abnormal result. [17][18][19][20][21][22][23][24] There is thus a potential for improving the screening programme. Women with a normal Pap smear have a low risk of subsequently developing ICC [25][26][27][28][29] and their incidence rate comprises the improvement potential of the screening programme, and the reference for evaluating guidelines for women with mild abnormalities.…”

mentioning

confidence: 99%

CIN 2/3 and cervical cancer in an organised screening programme after an unsatisfactory or a normal Pap smear: a seven-year prospective study of the Norwegian population-based screening programme

Nygård

Sauer

Nygård³

et al. 2004

J Med Screen

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Objectives:To estimate the risk of cervical intraepithelial neoplasia (CIN) 2/3 and invasive cervical cancer (ICC) in an organised screening programme after an unsatisfactory or a normal Pap smear. Setting:A seven-year prospective cohort study of the Norwegian population-based co-ordinated screening programme based on the actual diagnostic and screening procedures performed. Observations of 526,661 women with a normal index Pap smear and 21,405 women with an unsatisfactory index Pap smear were made during 3.26 million women-years. Methods:The risk of being diagnosed with CIN 2/3 or ICC was calculated by logistic regression for the rst two years of follow-up. The hazard of being diagnosed with CIN 2/3 or ICC for the women who were not diagnosed during the two rst years was estimated by non-parametrical survival regression. Results:

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Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire.

Cited by 110 publications

References 18 publications

Cervical screening, compliance and moral obligation

Cervical screening, compliance and moral obligation

Smear misclassification in a cervical cancer screening programme

CIN 2/3 and cervical cancer in an organised screening programme after an unsatisfactory or a normal Pap smear: a seven-year prospective study of the Norwegian population-based screening programme

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