Organisation and results of the cervical cytology screening programme in British Columbia, 1955-85

TLDR

A cervical cancer screening programme was launched in British Columbia in 1949 to detect preinvasive carcinoma. Since 1970, the programme has screened about 85 % of at‑risk women, examined over 500,000 smears annually, detected and treated more than 26,000 squamous carcinoma in situ cases, and reduced invasive squamous carcinoma incidence by 78 % and mortality by 72 %, with colposcopy further improving management and preventing a rise in invasive cancer among younger women.

Abstract

A screening programme to detect preinvasive carcinoma of the cervix was started in British Columbia in 1949. Since 1970 the number of women who have been screened at least once has been maintained at about 85% of the population at risk. More than 500 000 cervical smears are being examined each year in the central laboratory. There has been an appreciable increase in the number of cases and rates of carcinoma in situ seen since 1970, particularly in women between 20 and 30 years of age. Since the programme started over 26 000 cases of squamous carcinoma in situ have been detected and treated. The incidence of clinically invasive squamous carcinoma of the cervix has fallen by 78% during the period under review, and mortality from squamous carcinoma of the cervix has fallen by 72%. A colposcopy programme, introduced throughout British Columbia over the past 12 years, has been important in reducing the problems of managing preinvasive lesions, particularly in younger women. It is concluded that the reduction in morbidity and mortality from invasive squamous cancer of the cervix in British Columbia over the past 30 years is directly attributable to the province wide screening programme and that a large potential increase in invasive cervical cancer rates among younger women is being prevented.