The futility of smear follow up after radiotherapy for carcinoma of the cervix

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Abstract
In a study of 240 patients who had been treated with radiotherapy for invasive carcinoma of the cervix, there were 16 cases of central recurrence. Six of these 16 patients presented within 6 months of treatment, when cervical cytology is of little use, and in none of the remaining 10 was the cytology abnormal before the recurrent disease was obvious clinically. In only 2 of the patients without central recurrence (224 patients) were the smears suspicious and then disease recurrence confirmed. Taking cervical smears in patients treated with radiotherapy is uncomfortable for the patient and the quality of the smear is often poor. Our study shows it is of limited value in the screening for recurrence of cervical carcinoma.