Ned Tijdschr Geneeskd. 2004 Sep;148(36):1781-5.
No major difference between population screening for cervical carcinoma at the present screening interval of 5 years and the former interval of 3 years Vinkesteijn AS, Reinier de Graaf Gasthuis, afd. Gynaecologie en Obstetrie, Delft. To assess the effect of extending the screening interval from 3 to 5 years on the detection of premalignant changes and invasive cervical carcinoma in the restructured population screening programme. Retrospective follow-up study. The results were collected of the 1st round (1996-2000; 277, 377 women) and a part of the 2nd round (2001; 49,622 women; screening interval: 5 years) of the screening programme in Region West, the Netherlands. Histoscores for cervical intraepithelial neoplasia (CIN) 3 and squamous cell carcinoma (n/100 women investigated) and the hit count (sum of the histoscores for CIN 3, adenocarcinoma in situ and (micro)invasive cervical carcinoma) were calculated. Data of women with adenocarcinoma in situ and endocervical (adeno)carcinoma were recorded separately. The results of the 1st and 2nd round of the current screening programme (commenced in 1996) were compared with those of the historical screening programme that commenced in 1976 (screening interval: 3 years).
From the 1st to the 2nd round of the historical screening programme that commenced in 1976, the histoscores for CIN 3 (3.33, 1.88) and squamous cell carcinoma (0.53, 0.19) and the hit count (3.92, 2.15) all diminished significantly. The current restructured programme, which commenced in 1996, showed low starting values for all three parameters, comparable to those in the 2nd round of the 1976 programme; a further reduction (0.16, 0.08; p< 0.01) was seen only in the histoscore for squamous cell carcinoma. In both rounds of both programmes, the histoscores for adenocarcinoma in situ (0.02, 0.02, 0.05, 0.04, respectively) and endocervical adenocarcinoma (0.04, 0.06, 0.05, 0.04) remained stable. In the current cervical carcinoma screening programme, with a screening interval of 5 years, the hit count of serious abnormalities remained constant while the incidence of squamous cell carcinoma decreased; this is in contrast to the historical screening programme (commenced in 1976), when both the hit count and the histoscore for CIN 3 diminished significantly. There were indications that cervical screening has no beneficial effect on the prevention of cervical adenocarcinoma.Objectives:
Design:
Method:
Results:
Conclusion:
Please click on the required question.
- 1 What is cancer (malignancy)
- 2 What is meant by cancer staging?
- 3 How prevalent is cancer?
- 4 How prevalent are womens' cancers?
- 5 What causes cancer?
- 6 Is cancer a hereditary condition?
- 7 How can gynaecological cancer present?
- 8 How can we reduce the risks of the womens' cancers?
Reducing the Risks of Womens' Cancers.
- 9 What are screening tests?
- 10 What are the reactions to a diagnosis of cancer?
- 11 Is there a place for counselling when cancer is diagnosed?
- 12 Can personality alter the prognosis?
- 13 Is the incidence of deaths from the female cancers changing?
- 14 Is there a place for a holistic approach to cancer?
Cancer of the Cervix.
- 15 How prevalent is cervical cancer?
- 16 What causes cervical cancer?
- 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
- 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
- 19 Will pre-malignant changes of the cervix invariably lead to cancer?
Endometrial Cancer (Uterus)
- 20 What causes endometrial cancer?
- 21 Are there screening tests for endometrial cancer?
- 22 How does endometrial cancer present?
- 22a How can endometrial cancer be prevented?
- 22b How can endometrial cancer be treated?
Cancer of the Ovary.
- 23 How does ovarian cancer present?
- 24 How prevalent is ovarian cancer?
- 25 What are tumour markers?
- 26 Can we screen for ovarian cancer?
- 27 What is the relationship between infertility and ovarian cancer?
- 28 Can treatment of infertility increase the risk of ovarian cancer?
- 29 What is the relationship between oral contraception and cancer?
- 30 Can ovarian cancer be prevented?
- 31 I use talcum power. Could this increase my risk of developing ovarian cancer?
The Treatment Of Womens' Cancers
- 32 Can we predict the course of a cancer?
- 33 What treatment options are available for gynaecological cancer?
- Q32.33c What treatment options are available for ovarian cancer?
Cancer of the Vulva, Vagina and Fallopian Tube
- 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?
Breast Cancer
- 35 What is the incidence of breast cancer?
- 35 ?What is the cause of breast cancer?
- 35a What are the advantages of breast cancer screening - mammography - mammograms?
- 14 Is there a place for a holistic approach to cancer?
- 36 How often should breast screening be carried out?
- 37 Are there any problems having a mammogram?
- 38 Should I check myself for breast lumps?
- 39 One of my family developed cancer of the breast. Am I at increased risk?
- 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
- 41 What happens if a mammogram shows an abnormality?
- 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
- 42a Breast Cancer Treatment - What is available?
- 43 What is the relationship between breast cancer and the pill?
Web sites and Support Groups
- 44 Are there any support groups?
- 44 Are there any support groups?
- 45 Support Groups.
- 46 Breast Cancer Support Groups
- 47 Ovarian Cancer Support Groups
- 48 Endometrial Cancer Support Groups
- 49 Cervical Cancer Support Groups
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
- Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.
David Viniker retired from active clinical practice in 2012.In 1999, he setup this website - www.2womenshealth.com - to provide detailed
information many of his patients requested. The website attracts thousands of visitors every day from around the world.
Website optimisation (SEO) has became more than an active hobby. If you would like advice on your website, please visit his website Keyword SEO PRO or email him on david@page1-on-google.com.
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