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General Practice

Cancer Prevention in Primary Care: Screening for cervical cancer

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6949.241 (Published 23 July 1994) Cite this as: BMJ 1994;309:241
  1. J Austoker
  1. Cancer Research Campaign Primary Care Education Group, Department of Public Health and Primary Care, University of Oxford, Oxford OX2 6PE.

    Cervical screening has been shown to be effective in several countries, although not by means of randomised controlled trials. A screening programme has been in operation in the United Kingdom since 1964, but it has, in the past, been beset with problems of organisation, accountability, and commitment. The introduction in 1988 of a systematic call and recall system and the setting up of an NHS cervical screening programme national coordinating network has brought a greater sense of coherence. Coverage of the target population in England between 1989-90 and 1992-3 increased from 61% to 83%, and there is a strong indication that cervical screening is now beginning to reach those most at risk - namely, older women from lower social classes. Primary care is central to the overall success of the cervical screening programme. General practitioners are in a unique position to invite women for a smear test, to take smears, to ensure that abnormal smear test results are followed up, and to check on reasons for non-attendance. Numerous studies have looked at the involvement of general practice in cervical screening, identifying many ways in which the programme can be improved. Many practices are now running well organised and effective programmes.

    * This is the seventh in a series of articles looking at how cancer can be prevented in general practice

    Cervical cancer: current facts

    In England and Wales during 1988, 4467 new cases of invasive carcinoma of the cervix were registered (4940 in the United Kingdom as a whole), making it the eighth commonest cancer in women. Although only 15.5% of cases occur in women under 35, it is the most common cancer in this age group, accounting for 25% of all new cancers. Since the early 1970s there has been a significant increase in the incidence of both carcinoma in situ and invasive …

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