Papanicolaou smear screening and cervical cancer. What can you expect?

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Abstract
More than 90% of the total female population of 3 Swedish counties between the ages of 30-59 yr, 53% of women between 60-69 yr, and 25% of women older than 70 yr were screened for cervical cancer with the Papanicolaou smear over a 10-yr period. The uniqueness of the study is that in Sweden it is possible to follow up the entire population during their lifetimes via a population register, which has its roots in the 17th century, natural to Swedes but almost incomprehensible in the USA or UK. Every Papanicolaou smear taken was computer recorded and linked on an individual level to the cancer registry. There were 207,455 women followed up for 10 yr. No women were lost to follow-up. There was a 75% decrease in invasive cervical cancer incidence among women who had smears taken at least once during the 10-yr period. Among women who had never had smears taken, the incidence of invasive cervical cancer was 4 times as great as among women who were examined at least once. The system proposed by the Swedish Medical Board (at least 1 smear every 3 yr) for cervical cancer screening apparently can reduce the incidence of invasive cervical cancer to a level between 1 and 5 cases/100,000 women per year in a completely screened population.