The impact of the National Cervical Screening Programme on the presentation of cancer of the cervix in Canterbury

Aims. To assess the impact of the introduction of the National Cervical Screening Programme (NCSP) on the presentation of women with cervical cancer to Christchurch Women's Hospital (CWH), a tertiary referral center in Canterbury. Method. A retrospective review of the hospital notes of patients diagnosed with invasive cervical cancer from January 1988 to December 1990 and from January 1997 to December 1999. The patient characteristics, mode of presentation and staging during these two three-year study periods were compared. Results. There was a 21% decline in the number of cases of invasive cervical cancer treated at CWH from the Canterbury region from the first to the second study period. There was also a significant clinical down staging at presentation and a significant increase in women presenting with asymptomatic smear detected disease (p=0.004). These changes were less marked in women older than 50 years. There was no change in the relative proportions of different histological types. Conclusion. The results reflect a positive impact on the presentation of cervical cancer associated with the introduction of the NCSP in Canterbury. A significant decrease in mortality from cervical cancer in the region can be anticipated. Further emphasis needs to be placed on prevention of cervical cancer in women over 50 years of age.