Whiplash injury.

Abstract

Dr M C F Jenkins criticises our lack of a control group and suggests that the number of cases of carcinoma may have been underestimated because of losses to follow up. We found a highly significant excess of invasive cancer in women with an initial dyskaryotic smear compared with the number predicted from the incidence in the total population. Dr Jenkins suggests that we should have used a control group of screened women matched for age as background incidence rates derive mainly from unscreened women. If this is true, however, the rate of invasive cancer would be lower in a screened group, which would consist mainly of women with negative smears. The rate of subsequent invasive cancer in screened women would include components of both the false negative rate and spontaneously occurring cancers and is likely to be extremely low. Such a comparison would increase the relative risk conferred by an initial dyskaryotic smear. Also, the

Whiplash injury. A clinical review with emphasis on neuro-otological aspects

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