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Journal of Public Health Advance Access originally published online on February 21, 2008
Journal of Public Health 2008 30(2):171-177; doi:10.1093/pubmed/fdn008
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

The use of cervical screening history data to interpret cervical cancer incidence trends



Joanne Clare, Cervical Screening QA Information Assistant1

Diane Edwards, GIS Manager2

Helen Bagnall, Cervical Screening QA Research and Information Manager1

Philippa Pearmain, Deputy Regional Director of Cervical Screening Quality Assurance1

Gill Lawrence, Regional Director of Breast and Cervical Screening Quality Assurance1
1 West Midlands Cervical Screening QA Reference Centre, West Midlands Cancer Intelligence Unit, Public Health Building, The University of Birmingham, Birmingham, B15 2TT UK
2 West Midlands Cancer Intelligence Unit, Public Health Building, The University of Birmingham, Birmingham, B15 2TT UK

Address correspondence to Dr Gill Lawrence, E-mail: gill.lawrence{at}wmciu.nhs.uk


  Abstract

Background Regional Cervical Screening Quality Assurance Reference Centres maintain and improve the quality of their local cervical screening programmes by monitoring standards based on a range of outcome measures. The classification of invasive cervical cancer screening histories can aid the interpretation of cervical cancer incidence trends in cervical screening services.

Methods Cervical cancer incidence rates were calculated for cytology laboratory catchment areas, which reflected where local general practitioners sent cervical samples. After reviewing changes in invasive cervical cancer incidence rates in the West Midlands during the period 1988–2004 to identify unusual trends, a detailed retrospective screening history analysis was carried out for one local screening service.

Results An upward trend in invasive cervical cancer incidence in one laboratory catchment area was caused by an increase in cases occurring in women who had not been routinely screened. Quality assurance data provided supporting evidence for non-attendance at screening during this time.

Conclusions Assigning a screening status to invasive cervical cancers provides valuable information through which to understand the reasons for changes in cancer incidence with time in local screening services. These data can be used to identify areas of potential concern, thereby facilitating quality assurance activities.

Keywords: cervical cancer, cervical screening, geographical information systems (GIS), quality assurance, screening history


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