Summary
Cervical cytology material from 5,815 women who presented to General Practitioners throughout Ireland for routine cervical smears were referred to our Pathology Laboratory. The smears were reviewed retrospectively in order to report on the incidence of dyskaryosis and other abnormalities diagnosed on cervical cytology. Evidence of dyskaryosis was found in a total of 2.2% and “borderline” changes in a total of 0.3% of smears. Cytology and subsequent histology were compared in cases of significant cervical intraepithelial neoplasia. Comparison in cases of moderate and severe dyskaryosis showed precise correlation between the diagnosis of cervical intraepithelial neoplasia on biopsy and its prediction on cytology in 30 of 33 cases. Over a third of women screened were in their 4th decade and the highest incidence of dyskaryosis was in this age group. Only 10% of those screened were 50 years or over and a third were aged 40 years and over. These facts are of relevance with regard to the problem of targeting the population at risk in the long term planning of routine cytology screening services in this country.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Singer, A., Walker, P. The treatment of CIN: Conservative methods. Clin. Obstet. Gynecol. 1985: 12, 121–132.
Beral, V., Booth, M. Prediction of cervical cancer incidence and mortality in England and Wales. Lancet 1986: 1, 495.
Draper, G. J., Cook, G. A. Changing patterns of cervical cancer rates. Br.Med.J. 1983: 287, 510–12.
Wolfendale, M. R., King, S., Usherwood, M. M. Abnormal cervical smears: are we in for an epidemic? Br. Med. J. 1983: 287, 526–8.
Elliott, P. M., Tattersall, M. H. N., Coppleson, M., Russell, P., Wong, F., Coates, A. S., Solomon, H. J., Bannatyne, P. M., Atkinson, K. H., Murray, J. C. Changing character of cervical cancer in young women. Br. Med. J. 1989: 198, 188–290.
Anderson, G. H., Boyes, D. A., Benedict, J. L., Le Riche, J. C., Matisic, J. P., Suen, K. C., Worth, A. J., Milner, A., Bennett., O. M. Organisation and results of the cervical cytology screening programme in British Columbia, 1955-1985. Br. Med. J. 1988:296, 975–78.
Laara, E., Day, N. E., Hakama, M. Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet 1987: 1, 1247–1249.
Campion, M. J., McCance, D. J., Cuzick, J., Singer, A. Progressive potential of mild cervical atypia: prospective cytological colposcopic and virological study. Lancet 1986: 2, 237–40.
Melchers, W., van den Brule, A., Walboomers, J., de Bruin, M., Burger, M., Herbink, P., Meijer, C., Lindeman, J., Quint, W. Increased detection rate of Human Papillomavirus in cervical scrapes by the Polymerase Chain Reaction as compared to modified FISH and Southem-blot analysis. J. Med. Virol. 1989: 27, 329–335.
de Villiers, E-M., Wagner, D., Schneider, A., Wesch, H., Miklaw, H., Wahrendorf, J., Papendick, U., zur Hausen, H. Human papillomavirus infections in women with and without abnormal cervical cytology. Lancet 187: 2, 703–706.
Evans, D. M. D., Hudson, E. A., Brown, C. L., Boddington, M. M., Hughes, H. E., Mackenzie, E. F. D., Marshall, T. Terminology in gynaecolgical cytopathology: report of the Working Party of the British Society for Clinical Cytology. J. Clin. Pathol. 1986: 39, 933–944.
Meisels, A., Fortin, R., Roy, M. Condylomatous lesions of the cervix: II. Cytologic, colposcopic and histopathologic study. Acta Cytol. 1977: 21, 279–390.
Robertson, J. H., Woodend, B. E., Crozier, E. H., Hutchinson, J. Risk of cervical cancer associated with mild dyskaryosis. Br. Med. J. 1988: 297, 18–21.
Jordan, J. A. Minor degrees of cervical intraepithelial neoplasia. Br. Med. J. 1988: 297, 6.
McCormick, J. S. Cervical smears: a questionable practice? Lancet 1989: 2, 207–209.
IARC Working Group on Evaluation of Cervical Cancer Screening Programmes. Screening for squamous cervical cancer: duration of low risk after negative results on cervical cytology and its implication for screening policies. Br. Med. J. 1986: 293, 659–664.
O’Connor, T., Kealy, W. F., O’Mahony, G. A., Plant, L., Shorten, G., Tong, W. Carcinoma of the cervix: a changing pattern? Ir. Med. J. 1986: 79(5) 122–124
Kinlen, L. J., Spriggs, A. I. Women with positive cervical smears but without surgical intervention. A follow-up study. Lancet 1978: 2, 463–465.
Evans, D. M. D., Sanerkin, N. G. Cytology screening error rate. In Cytology Automation (ed. D. M. D.Evans), Livingstone, Edinburgh. 1975: 5–13.
Evans, D. M. D., Shelley, G., Cleary, B., Baldwin, Y. Observer variation and quality control of cytodiagnosis. J. Clin. Pathol. 1974: 27, 945–950.
Elwood, J. M., Cotton, R. E., Johnson, J., Jones, G. M., Curnow, J., Beaver, M. W. Are patients with abnormal cervical smears adequately managed? Br. Med. J. 1984: 289, 891–894.
Giles, J.A., Hudson, E., Crow, J., Williams, D., Walker, P. Colposcopic assessment of the accuracy of cervical cytology screening. Br. Med. J. 1988: 296, 1099–1102.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dolan, J., Ryan, E., Thornhill, M. et al. Review of an Irish cervical smear service. I.J.M.S. 159, 233–236 (1990). https://doi.org/10.1007/BF02937374
Issue Date:
DOI: https://doi.org/10.1007/BF02937374