Prophylactic cytological investigation for cervical cancer in relation to stage at diagnosis: a study of 420 women in Denmark.

Despite widespread cervical smear testing 500-600 cases of cancer of the cervix are still diagnosed each year in Denmark, with over 200 deaths. The distribution of the different stages of cancer among 420 women who were diagnosed during 1983 was correlated with the number of previous cervical smears, whether done purely for screening reasons or for minor gynaecological problems. Of the women with cancer 56% had never been screened, and among these 42% were diagnosed at stage 1; 19% had been screened once; 61% of them at stage 1. The remainder (25%) had been screened at least twice, and 81% of them were diagnosed at stage 1. Among the patients who had been screened at least twice, with the last screening not more than three or five years ago, about 90% were diagnosed at stage 1 and the rest at stage 2.The introduction of cervical smear testing will thus mean a considerably better stage distribution among cases which develop invasive cancer of the cervix, and both case fatality and mortality rates will be reduced by organized programmes, which have better participation rates than disorganized use of cervical smears.