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31
Detection Rate
A "positive" smear is one showing cells which the cytologist considers
to be premalignant. During the four years - 1966 to 1969 - there have been
15 positive smears reported out of 2,375 - a rate of 6.3 per 1,000 which is
very close to positive rates of 6.1, 6.7 and 6.9 per 1,000, reported from
similar surveys in Edinburgh, Aberdeen and Oxford.
Follow-up of patients
The population turnover in Central London is high and even with the
rapid reporting of a positive result, there has been some difficulty in
tracing the woman concerned. There are many other cases, however, where
minor gynaecological conditions are found and women are referred to their
own doctors for treatment and asked to attend for further testing in 3,
6 or 12 months. Three appointments are sent to each woman - often without
result - and in many cases, it has proved impossible to make any further
contact with her.
Screening of "Non Volunteers"
Although the figure of voluntary attenders is low, a much larger number
of women, mostly those of childbearing age, are having smears taken when
they attend hospital obstetrical and gynaecological departments and family
planning clinics.
At the four hospitals where the great majority of Kensington and
Chelsea women are confined, smears are taken as a routine at ante-natal or
post-natal clinics and during 1969, 1,600 women are known to have been
examined. At least another 1,000 were examined at clinics of the Family
Planning Association and an unknown number at hospital gynaecological
departments and other maternity hospitals.
It is very likely, therefore, that the total number of women
screened during 1969 may well have been as high as 4,000 but 75 to 80 per
cent of these were under 35 and therefore not in the "at risk" population.
In conclusion:-
1. In spite of considerable national and local propaganda, as with
cigarette smoking, the risk of cancer does not provoke much preventive
action and there is no great demand for the screening service.
2. The service provided by the Council at present is more than adequate
to meet the demand. Over the four years reviewed there have been only
2,375 attendances out of a possible total of 3,454.
3. Many women who do not elect to attend cytology clinics are being
screened in the course of other medical examinations and investigations
but the great majority of these are under 35 and are not in the "at
risk" group.
4. There is a hard core of women over 35 who are "at risk" and who do not
seem to be reached or influenced by publicity and propaganda and it is
to these that future effort will have to be directed if the screening
programme is to be effective and deaths from cervical cancer prevented.
FAMILY PLANNING
Family planning services within the borough continued to be provided
by the West London Branch of the Family Planning Association. Regular
sessions are held each week at five premises in the borough, two of these
being Council Health Centres,which are used by the Association free of
charge.