Geirsson G
IARC Sci Publ. 1986(76):239-50.
Mass screening for cervical carcinoma in Iceland over the past 20 years (1964-1983) has resulted in a 60% drop in the incidence of and mortality from the disease in the country. A study of the screening histories of the 77 incident cases of grossly invasive cervical cancer diagnosed in Iceland in the past nine years showed that 70% of the tumours occurred in women who had failed to attend screening or had done so very irregularly. Approximately 20% of the cervical cancers were either diagnostic or therapeutic failures, in that the women had been diagnosed with cytological changes but this did not result in the prevention of the tumour. The remaining 10% of the incident cervical carcinomas seemed to have escaped cytological detection and proved to be unusual types of cancer. Prevention of the last cases of cervical cancer is becoming increasingly laborious because of difficulties in maintaining interest among the public to attend regular screening. Women may escape surveillance of a cytological abnormality unless they are constantly reminded about follow-up visits. A small, but significant number of the tumours may continue to escape detection because of their unusual nature, but alterations in sampling techniques and increased awareness of the rarer forms of the disease could alter this.
在过去20年（1964 - 1983年）里，冰岛针对宫颈癌开展的大规模筛查使得该国该疾病的发病率和死亡率下降了60%。一项对冰岛过去九年确诊的77例严重浸润性宫颈癌病例筛查史的研究表明，70%的肿瘤发生在未参加筛查或筛查非常不规律的女性身上。约20%的宫颈癌属于诊断或治疗失败，即这些女性已被诊断出细胞学改变，但这并未预防肿瘤的发生。其余10%的新发宫颈癌似乎躲过了细胞学检测，且被证明是不常见的癌症类型。由于难以维持公众定期筛查的积极性，预防最后这些宫颈癌病例变得越来越困难。除非不断提醒女性进行后续随访，否则她们可能会逃过对细胞学异常的监测。一小部分但数量可观的肿瘤可能因其不寻常的性质而继续无法被检测到，但采样技术的改变以及对该疾病罕见形式的认识提高可能会改变这种情况。
