Population screening for cervical cancer in the region of Nijmegen, The Netherlands 1976-1985.

In this study the results of a 9-year cervical screening program in the region of Nijmegen, The Netherlands are presented. All women aged 35 through 54 were invited every 3 years for a cervical smear. Overall attendance rates were 74%, 67%, and 63% at first, second, and third screening, respectively. The number of histologically confirmed severe epithelial abnormalities discovered in women who were screened for the first time was 3.8 per thousand smears, 1.0 per thousand in women who were screened twice and 0.7 per thousand in women who were screened three times in the program. Three years after the start of the screening program the incidence of invasive squamous cell cancer started to decline in the women aged 35 through 54 years. On the basis of the results of this study we may conclude a screening policy with an interval of 3 years to be a safe procedure. Whether this interval is the most efficient cannot be concluded. We have the impression that an interval of 4 to 6 years may lead to comparable results.