Six years' audit of laboratory workload and rates of referral for colposcopy in a cervical screening programme in three districts.

Abstract

Objective-To determine laboratory workload and rates of referral for colposcopy in a three district cervical screening programme during 1983-9 to assess the feasibility of accommodating call up of all women at risk, recall at three year intervals (now five year intervals), and investigation of women with all degrees of abnormality.Design-Analysis of computerised screening histories dating back to 1977 of women screened in the Avon cervical screening programme.Setting-Three district health authorities covering the population of Bristol and Weston-super-Mare, comprising 800 000 people, of whom 250 000 were female residents aged 20 to 64.

Use of pap‐smears in a population without a mass screening program

“…We found that a substantial proportion of the smears (about 25%) were from the follow-up of at least one cytological or histological diagnosis. Similar observations have been presented elsewhere with a proportion of follow-up smears between 12% and 30% (19). This systematic investigation and follow-up of positive, suspicious or atypical smears may be a possible explanation for the C Actcl Ohurt Ginetol Scand 73 (1994) 80.4%.…”

Human papillomavirus (HPV) typing as an adjunct to cervical cancer screening

“…The baseline assumption of the authors was that the prevalence of high-risk HPV infections in histologically normal women is the same in both developed and developing countries 41 . Even a prevalence twice as high in developing countries would not significantly affect the results, except for increasing the number of colposcopies, a frequent source of workload increase in many of the screening programmes 44 . Not unexpectedly, if cervical cancer is supposed to develop only in the presence of high-risk HPV types, the advantages of HPV testing compared with conventional cytology would be accentuated.…”

Cervical screening

“…Avon dealt with it in 1987, described its approach in the BMJ in 1991,8 and has been cited as an example of good practice 9. During 15 years with a strict five year interval, returning non-indicated tests to the sender, we receive perhaps three queries a year from women, their partners, their members of parliament, or the press.…”