Screening for cancer of the uterine cervix in Greenland.

During 1986-1991 diagnostic Pap smear examinations were performed in 10,998 Greenlandic women, corresponding to 60 per cent of all women over 14 years of age. Of these, more than half had at least two smears taken. Three-year screening coverage of women over 14 was 40 per cent. Screening intensity was highest in the 25-39 age group, where more than half the population was covered. Compared to the previous 10-year period, rates for all precursor lesions were considerably lower, most pronounced for carcinoma in situ. Such findings probably reflect previous screening experience rather than reduced background risk. However, cytological screening activity failed to reduce the incidence of invasive cancer-one of the world's highest. Most cancer patients had slipped through the system because of failure to be screened at all (57%) or failure of adequate follow-up (23%). Infrequent screening and possible false-negative results seem to account for most of the remaining cases. Cancer patients with a history of failed follow-up reflected an inadequate follow-up management over the last 15 years of women with abnormal smear results. The findings of this study were similar to results for 1976-1985. A nationwide, centrally organized mass screening programme is recommended.