CARCINOMA AND DYSPLASIA OF THE CERVIX: A COMPARISON OF RATES FOR NEW AND RETURNING POPULATIONS.

Abstract

Discovery rates of dysplasia preinvasive carcinoma and invasive carcinoma in new (19192 women) and returning (10502 women) populations using the Papanicolaou smear are analyzed. About 92% of the new population was white and 8% nonwhite; 24% were nulliparous. The returning population were women returning for examination after a previously diagnosed negative smear or diagnosed dysplasia. Average rates per 1000 of 5.4 for dysplasia and 5.1 for in situ cancer of the cervix were found for the new population. The rate for dysplasia was higher than that for preinvasive cancer in the 20-29 age group. Invasive cancer increases with age. Returning women previously negative for cancer and dysplasia had a dysplasia rate of 2.4/1000. Relatively few cases of cancer originate in the population previously diagnosed dysplasia (94 women) had the following outcomes: 48% remained dysplastic 40% returned to normal and 12% progressed to cancer. The in situ rate in this group was 106/1000 and the Stage 1 cancer rate was 11/1000. It is concluded that dysplasia may be related to carcinoma in situ as a precursor state in young women. The Papanicolaou smear proved to be a very reliable and sensitive screening test for cancer of the cervix.