Cytological Screening for Cancer in a Venereal Disease Program

Abstract

PUBLIC clinics established for diagnosis and treatment of venereal disease have a unique opportunity and obligation to initiate programs to screen female patients for early cancer of the genital tract. Impetus for such a program in Seattle-King County, Wash., arose from the assumption that this population group was not receiving adequate cancer prevention care. Since the women were being admitted to the clinic service for diagnosis and treatment of possible venereal disease, relatively little addi¬ tional medical effort would be required to screen them for cancer of the cervix and uterus by exfoliative cytology. A practical screening pro¬ gram, however, would require effective followup on final diagnosis and treatment as most of the patients were known to be medically indigent or semi-indigent. The proposed program, as endorsed by the local medical society, called for screening only the female population which ordinarily at¬ tended the Seattle-King County venereal dis¬ ease clinic. We were not interested in changing our clinic to a community cancer detection cen¬ ter. The program would be primarily a demon¬

Pilot study of cervical cytology screening in a sexually transmitted diseases clinic.

“…After vigorous contact tracing and numerous letters and telephone calls 55 (80%) attended. Of these 55, 18 (33%) gave less severe reactions than at first (no abnormality, inflammatory changes, or metaplasia), whereas 28 (50%o) gave the same results (atypia or dysplasia), and nine (17%) showed a more severe grade of dysplasia or carcinoma in situ. We also referred these 37 patients for colposcopy; thus 42 patients were referred for colposcopy, 844% of the total study population.…”

“…24 Unfortunately few reports of cytology screening in STD clinics have been published, and we are only aware of six previous reports, five of which were published in the 1950s and 1960s. [25][26][27][28][29] The two most recent reports came from Birmingham, England, in 333 196725 and Seattle, United States, in 198030 and gave incidences of dysplasia and carcinoma in situ of 69 9% and 11 4%o respectively. These figures were both well over five times the incidence of abnormal cytology reported by their countries' national screening programmes.…”

Estudios epidemiológicos y de detección precoz del cáncer en la Reclusión Nacional de Mujeres de Bogotá, D. E. Colombia

“…Anota este mi s mo autor e l aumento de citologías pos itivas en pacientes de baja clase socio-económica, como lo era la gran mayoría de las nuestras . Las cifras encontradas por Pedersen ( 14) y Margaret y Charles MacLennan ( 8) están en los promedios anotados. En general pues, nuestros hallazgos corresponden a los encontrados por varios autores ( 4), tanto en nuestro medio como en el extranjero.…”