Achievable laboratory standards; a review of cytology of 99 women with cervical cancer.

The Working Party guidelines are a significant advance in the audit of the National Health Service Cervical Screening Programme (NHSCSP), the priority of which is to reduce mortality and morbidity from cervical cancer. This study was undertaken to apply the guidance on review of screening history to a series of 99 women with invasive cervical cancer diagnosed in one centre during a 9 year period. The majority (approx. 64%) of these women had not been screened within the 5 years preceding diagnosis, 25% had negative, inadequate or abnormal smears and 6% had previous treatment for cervical intraepithelial neoplasia (CIN). In four patients diagnosis was delayed. No standards are yet available to test the results of this series of women. Cervical cancer is relatively uncommon, and for data to be aggregated and compared across the UK, it is important that strict criteria are developed and applied to ensure that recruitment to the Working Party categories is uniform and not open to local interpretation. Full review and documentation of screening history should be mandatory for all women who develop cervical cancer.