Reasons for Cervical Cancer despite Extensive Screening

Abstract

The evidence strongly suggests overascertainment of cervical cancer, which conceals the success of screening, and also suggests that much attention must be given to clinical management of detected lesions in cervical screening. Care is needed in applying accurate histopathological criteria when making a diagnosis of invasive squamous cancer, to separate squamous cancer from other malignant tumours of the cervix, and in data transfer to cancer registries.

Cervical Cancer After Multiple Negative Cytologic Tests in Long-Term Members of a Prepaid Health Plan

“…9,[16][17][18][19][20][21] Some European studies have defined the incidence of cervical cancer following negative cytology by defining the number of cases occurring and the number of women participating in the screening program. 22,23 Using cytologic outcomes in U.S. women with ≥ 3 prior consecutive negative Pap tests, investigators recently estimated that over the 3 years following the last negative Pap test, cancer risk ranges from 1-9 in 100,000, with younger age groups having higher risk estimates. 24 Our study was unique in that we estimated cancer risk among U.S. women known to have been diagnosed with cervical cancer after several documented normal cytologic tests.…”

Screening histories of women with CIN 2/3 compared with women diagnosed with invasive cervical cancer: a retrospective analysis of the Norwegian Coordinated Cervical Cancer Screening Program

“…The introduction of organized cervical cancer screening programs has had a major impact on the incidence of ICC [1][2][3], However, countries with well-organised screening programs have notably different incidence rates of ICC, and in some instances significantly higher than countries without [2,4]. Furthermore, not all ICC are prevented, even among women who have complied with screening program guidelines [5][6][7][8][9][10][11][12]. Improvements to screening programs have therefore focused on the most appropriate screening interval [13].…”

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

“…[46][47][48][49] However, studies of the screening history of women who have developed ICC reveal that while the majority of the cases were due to women not having been previously screened, up to 30% of the women with ICC had negative Pap smears within three years of diagnosis. 10,19,31,32,46,50,51 …”