Screening for cervical intraepithelial neoplasia in Dundee and Angus 1962-81 and its relation with invasive cervical cancer.

Cervical cytology screening started in Dundee and Angus in 1962 and apart from the five-year recall is largely opportunistic, the screening policy being in line with the recommendations of the Scottish Health Service Planning Council (1978) report. In the 1977-81 period the screening rate was 47% (maximum 70-80% in the 20-40 age-group). The incidence rate of cervical intraepithelial neoplasia 3 varied from 3.2/1000 in women under age 35 to 0.5/1000 in those over age 55. The average yearly incidence and death rates per 100 000 women over the age of 20 were calculated from gynaecological cancer registry records. In women between the ages of 35 and 54, there was a progressive reduction in incidence from 40.89 during the five-year period before screening to 17.11 between 1977-81, with deaths falling from 20.71 to 7.33. Incidence figures recorded by the East of Scotland Cancer Registration Office were practically identical with those of the gynaecological cancer registry, but the many inaccuracies in death certificate records led to an over-recording of deaths in women over 55 between 1972 and 1981.