Brenner H, Wiebelt H, Ziegler H
Institut für Epidemiologie und Biometrie, Deutsches Krebsforschungszentrum, Heidelberg.
Geburtshilfe Frauenheilkd. 1990 Apr;50(4):304-9. doi: 10.1055/s-2007-1026482.
The efficacy of the nationwide screening programme for cervical cancer in the Federal Republic of Germany, which has been in effect since 1971, has never been checked by means of controlled epidemiological studies. Therefore routinely collected mortality and morbidity data are up to now the only indicators of potential progress in early detection. Mortality statistics of cervical cancer are of restricted value due to lack of specificity regarding the cause of death on death certificates. Data of the population based cancer registry of Saarland are used to investigate trends in terms of age, stage and birth cohort-specific detection rates of cervical cancer and its preinvasive precursors. There was a substantial decrease in incidence rates of invasive cervical cancer, which was most pronounced for advanced tumour stages and young and middle-age groups and which is consistent with comparable results in other countries following the introduction of screening programmes. However, a selection effect of the screening programme suggested by a decrease in survival rates of women with invasive cervical cancer in the 1980ies, must also be taken into account.
