PATTERNS OF PAP-SMEAR SCREENING IN WOMEN DIAGNOSED WITH INVASIVE CERVICAL-CANCER

The purpose of this study was to gather data about the extent and nature of the observation that many women with invasive cervical cancer were reporting a history of regular Pap smears. A retrospective exploratory/descriptive design was used to examine and characterize the Pap smear histories of women with invasive cervical cancer. The study population consisted of women (n = 102) with invasive cervical cancer who attended the study institution over a 3-year period. Forty-seven percent of 101 evaluable cases had participated in regular Pap smear screening, as defined, yet were diagnosed with invasive cervical cancer. Twenty-six percent of women were diagnosed at the time of a routine planned Pap smear, with 64% seeking an appointment because of symptomatology. Forty-four percent had a biopsy at the time of presentation to their physician because of an identifiable lesion, as compared with the sequence of abnormal cytology with confirmatory biopsy following. The data were suggestive of the Pap smear being a less sensitive screening tool for adenocarcinoma histology. The Pap smear as a screening tool had made a significant contribution to reducing invasive cervical cancer. However, as currently used, it has not been the complete answer. Research is needed to definitively identify the limitations of the Pap smear as it pertains to quality control (collection and evaluation) in practice and ability to detect various cervical histologies, in addition to how current and new techniques could be incorporated to maximize diagnosis of preinvasive cervical cancer.