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Experiments in automatic photoscreening are now well advanced and if proved
successful will greatly aid in this most rewarding preventive field.
There must be a close link between the pathologist, gynaecologist, clinic medical
officer and general practitioner, because it is imperative for women showing abnormal
smears to have further investigation or treatment, preferably in the hospital where
the smear was diagnosed.
The need for unlimited availability of this service is emphasised by the results
obtained. Six cases of malignancy have been detected in the pre-symptomatic
stage, i.e. when treatment can assure 100% cure. In addition, many other morbid
conditions requiring treatment have been found. Special acknowledgement is due
to Dr. Graham Thomas, Consultant Pathologist to the Greenwich District Hospital
and Dr. H. Barnett, Consultant Pathologist to Lewisham Hospital for their cooperation.
There is some evidence that defects of personal hygiene in the male and female
may be associated with cancer of the uterine cervix. It has also been observed that
where the male circumcision is practised, the incidence of cancer of the cervix is
significantly less.
In view of the fact that cancer occurs more frequently in the breast than in the
uterus, we are trying out the possibility of linking screening for breast tumors at
these clinics.
Eventually general practitioners will be able to use cervical cytology smear facilities
without restriction and with the expansion of services it should be possible to
provide a routine and repeat service for all at risk.
It is hoped that action now being taken by the Ministry of Health and Regional
Hospital Boards will, in a short time, remove the difficulties the laboratories experience
in extending their services.
SCHOOL HEALTH
The health and well-being of Lewisham schoolchildren remains high. Children
are medically examined on entry to primary school, at the age of seven years, or on
transfer to secondary school and finally at school leaving age. A comprehensive
annual examination is also carried out, for vision defects, skin complaints and
personal hygiene.
A number of School doctors have commented on temporary hearing defects
produced by chronic upper respiratory tract infection. All children suffering from
protracted nasal discharge, recurring attacks of sore throat or tonsillar hypertrophy
are referred for treatment. Impairment of hearing may affect their progress at school.
Upper respiratory tract infection, asthma and bronchitis are the chief causes of
absenteeism. In some cases attacks of asthma are so frequent and so incapacitating
that special day open air school admission is sought to ensure continuity of education
and adequate treatment.
Heart and circulatory disease is generally on the decrease due to a fall in the incidence
of acute rheumatism. The evaluation of heart murmurs is one of the more
difficult problems facing the School doctor. Coarctation of the aorta is perhaps the
most important congenital heart disease to be detected early and treatment is most
rewarding. Femoral pulses are investigated as a routine by all school doctors.
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