Persistent carcinoma in cervical cancer screening: non-participation is the most significant cause.

OBJECTIVE

It was the aim of this study to determine the screening history of all invasive cervical carcinomas between 2004 and 2009 in one of the Federal States of Germany.

STUDY DESIGN

The pooled data sets of all in-state laboratories, corrected and supplemented by data of the State Cancer Registry, were used. The screening histories of all patients, their age and tumor types were collated and analyzed.

RESULTS

Of 617 patients with invasive carcinoma of the cervix, 373 (60%) had not had a cervical smear within the past 5 years. In 188 patients (31%), an incomplete screening history was found, whereas only 9% of women had participated regularly. In non-participants, late tumor stages (stage T1B and higher) were predominant and found in 86%. In contrast, in the group with regular screening histories more than half of all cases (54%) were microinvasive carcinomas (stage T1A) with excellent prognosis. Lack of follow-up or refusal of treatment by patients played a minor yet significant role.

CONCLUSIONS

Non-participation is still by far the most common reason for persistent cases of cervical carcinoma in the German screening program.