The delayed diagnosis of invasive carcinoma of the uterine cervix.

While an effective method of screening for uterine cervical cancer is available, utilization of that method has been less than satisfactory in the high-risk indigent population of Louisiana. From 1984 through 1987, 171 new cases of invasive squamous cell carcinoma and 149 new cases of squamous carcinoma in situ of the uterine cervix were examined and/or treated at the Charity Hospital of Louisiana in New Orleans. In the 1984 group, 23 patients of the invasive and no patients of the in situ group died, giving a 5-year survival of 43% and 100% respectively. During the 4 years in question, 84 (49%) patients in the invasive group and 2 (1.3%) in the in situ group had no record of having had a previous cervical cytologic examination. Participation by nongynecology staff physicians, nurses, and nurse's aides in the charity hospitals and clinics in New Orleans and throughout the state could possibly remedy this problem.