Screening frequency and histologic type influence the efficacy of cervical cancer screening: A nationwide cohort study.

OBJECTIVE

To evaluate the influence of age, screening interval, and histologic type on the effect of Pap smears in cervical cancer screening.

MATERIALS AND

METHODS

Data were retrieved from the Taiwan National Cancer Registry and Cervical Cancer Screening Registration System for the period from 2002 to 2010. Age, Pap smear interval, FIGO stage, and histology were further analyzed.

RESULTS

A total of 12,294 women with cervical cancer were enrolled, including 10,040 with squamous cell carcinoma (SCC), 1720 with adenocarcinoma (ADC), 401 with adenosquamous carcinoma (ASC), and 133 with small cell neuroendocrine carcinoma (SMC). Women who had a Pap smear at an interval of <3 years had a significantly higher proportion of stage I disease than women who had never undergone cervical cancer screening (p < 0.0001). Greater than 40% of women with SCCs in each age group had never had a Pap smear; however, women with ADCs were predominantly in the younger age and greater than 40% of women with ADCs had Pap smear at intervals < 3 years.

CONCLUSIONS

Pap smear is more effective in screening for cervical SCCs compared to cervical ADCs. Improving adherence to screening recommendations is important for the prevention of cervical SCC, especially in elderly women.