Invasive cervical cancer audit: why cancers developed in a high‐risk population with an organised screening programme

Please cite this paper as: Herbert A, Anshu, Culora G, Dunsmore H, Gupta S, Holdsworth G, Kubba A, McLean E, Sim J, Raju K. Invasive cervical cancer audit: why cancers developed in a high‐risk population with an organised screening programme. BJOG 2010; Objectives To investigate why invasive cervical cancers developed in a high‐risk urban population with an established screening programme and to place cancers in the context of high‐grade cervical intraepithelial neoplasia (CIN) and cervical glandular intraepithelial neoplasia (CGIN) diagnosed during the same period of time. Study design Observational study of CIN2+ (CGIN, CIN3 and CIN2) and invasive cervical cancer diagnosed at Guy’s and St Thomas’ NHS Foundation Trust in 1999–01, 2002–04 and 2005–07 and audit of screening histories of women with invasive cancer analysed according to route to diagnosis, histological type and International Federation of Obstetrics and Gynecology (FIGO) stage. Results There were 133 invasive cancers, 53 CGIN, 1502 CIN3 and 1472 CIN2. Screen‐detected cancers in asymptomatic women comprised 48.9% of cancers and were successively more likely to be in younger age groups (P = 0.03); all except one were stage IA or IB1. Screen‐detected IA cancers were more likely (P