4 research outputs found
Positive diagnostic values and histological detection ratios from the Rotterdam cervical cancer screening programme
BACKGROUND: In organized screening programmes for cervical cancer,
pre-cancerous lesions are detected by cervical smears. However, during
follow-up after a positive smear these pre-cancerous lesions are not
always found. The purpose of the study is to analyse positive diagnostic
values of smears of at least mild dysplasia, made under the organized
screening programmes in the Rotterdam area (1979-1991), and detection
ratios of histologically confirmed CIN > or =3, among women participating
in these screening programmes. METHODS: Positive diagnostic values and
histological detection ratios, by age and history of previous smears,
recorded during the national screening programme (1989-1991), were
compared with those of the experimental cervical cancer screening project
(1976-1984). RESULTS: The positive diagnostic value of a smear with at
least severe dysplasia (histologically confirmed CIN > or =3) remains
approximately 78%. For smears with mild and moderate dysplasia only lower
limits of the diagnostic value could be determined. This was 9% for a
smear with mild dysplasia obtained during the national screening programme
and 25% and 35% for smears with moderate dysplasia taken during the
experimental and national screening programmes respectively. Histological
detection ratios for CIN > or =3 in the three rounds of the experimental
screening project were 4.7, 2.9 and 1.9. In the first round of the
national screening programme the ratio was 4.7, and about three times
higher in younger compared to older women. CONCLUSION: Immediate referral
for colposcopy after a smear showing moderate dysplasia seems
questionable. Whether the increased detection ratio among young women
indicates a rise in the risk of cervical cancer is unclear