A retrospective study of the history of uterine cervical cancer screening before being diagnosed as cancer

Objective : We reviewed the history of uterine cervical cancer screening preceding cancer diagnosis. Study Design : (1)We studied the history of uterine cervical cancer screening before cancer was diagnosed in 70 cases. (2)Among cases diagnosed as CINIII or invasive cervical cancer, 22 subjects had negative annual Pap smears for more than 3 years. One gynecologist and two cytotechnologists reviewed slides of these 22 cases, included 5 slides not available or reviewed. Results : (1)In 17 of 70 cases, disease progressed from dysplasia to cancer during follow-up. Of the 70, 53 were found in mass screening. Of the 53, 43 had no screening history. Ten had a history of “negative” results in previous mass screening. (2)Two cases were reviewed as truly negative. Of 8 having a few dysplastic cells, 1 had a few dysplastic cells, 7 had a few dysplastic cells and ASC-US, 7 had atypical cells, 3 had ASC-US, 1 had atrophic cells, 1 had multinucleated cells, and 2 had atypical cells that could not be classified. Conclusion : The frequency of the cervical cancer found in mass screening is higher than the frequency found while following up dysplasia. We expect the uterine cervical screening accuracy to improve if Bethesda System 2001 is used in Japan.