Morbidity From Cervical Cancer: Effects of Cervical Cytology and Socioeconomic Status2

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Abstract
The rates of newly diagnosed cases of invasive cancer of the cervix uteri are presented for Louisville and Jefferson County, Kentucky, for an 11-year period. A 3-year precytology period, 1953–55, with an age-adjusted rate of 33.8 per 100,000 females, served as a baseline. During the next 3 years, which encompassed the onset of mass cytologic screening, the rates rose to 40.3, an increase of 19.2 percent. During the next 4 years, the rates approximated those of the precytology period. Data for 1963 indicated a 22.7 percent reduction of the invasive cervical cancer rate. The proportion of cases in clinical stage I increased, the rise being much greater for the cases detected cytologically when compared with other cases. For 1959–62, a reduction of 43 percent was recorded for stages II through IV among white women under 50 years of age. In all years studied, there was a marked association between the development of cervical cancer in the Caucasian race living in a lower socioeconomic area of Louisville. Nonwhite rates were similar to white rates in the lowest socioeconomic area. The increased number of cases early in the mass-screening program and the need for future observations to evaluate the effectiveness of cytologic screening are discussed.