Evaluation of the organization of the mass screening program for cervix cancer in northern Limburg
Spee, M.H.; van Gastel, J.
Nederlands Tijdschrift Voor Geneeskunde 136(47): 2327-2331
1992
ISSN/ISBN: 0028-2162 PMID: 1461304 Document Number: 397834
The 1990 programme for screening of cervical cancer in North Limburg in the Netherlands was evaluated with a view improving the programme. Information was gathered from women in the screening programme, general practitioners, the health insurance company, the laboratory, and the city councils. With data from literature estimates were made of the effects of the screening in the region. All participants in the screening programme were satisfied with the set-up of the programme. 52% of all women did respond to the invitation for a smear, (in the first 7 months 3620 smears were made). 31% of the women did not need a smear because the uterus had been completely removed or because a smear had been made shortly before. 5% of the women did not receive an invitation. Only 11% of the women who needed a smear did not respond to the invitation, because of lack of time or objections. A so-called 'protection degree' for cervical cancer of 83% was achieved. The degree of protection was the same for different villages, age groups and income levels. The invitation of 12,000 women each year for a smear, leads to an estimate of 185 follow-up tests, detection of 20 women with abnormal results, unnecessary (minor) treatment of 12 women, prevention of two to three major treatments and of one to two deaths per year. Because of the limited positive effects and the relatively large negative effects the authors think that the cervical screening programme is questionable.