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57
CERVICAL CYTOLOGY
The number of new patients seen in 1968 at the four weekly cervical screening sessions totalled
2,295, an increase of 287 on the previous year; of these 600 were seen at Ebury Bridge, 595 at
Harrow Road, 594 at St. Marylebone and 506 at Hallfield. In addition, 135 women had a further
cervical smear examined, increasing the number of screening examinations carried out during the
course of the year to a grand total of 2,430.
Eight of the women seen for the first time proved to have a pre-cancerous condition, and it is
interesting to note that three of these were under the age of 35. Arrangements for the necessary
treatment were effected promptly through the general practitioners concerned. Particularly
heartening was the case of the 29 year old mother with one child, who had been unable to conceive
again for some years. She visited one of our clinics in January, when a cervical smear was found to
be positive necessitating admission to hospital the following month for a small operation which
was successful in removing the abnormal tissue. Before the end of the year this mother had had
another child and all cervical smears taken since the operation had proved negative.
Attendance at a cytological clinic frequently acts as the spur to do something about gynaecological
ailments producing symptoms of which the individual has often been aware for some weeks or even
months. Thus, in 1968, no fewer than 723 of the 2,295 new patients were advised to consult their
doctors about minor infections or local abnormalities detected incidentally. This included 17 women
who were found to have abnormalities of the breast on routine examination.
In summary, during the year approximately one woman in every 300 attending a City Council
screening clinic for the first time was found to have a positive cervical smear, one in every three
women had to be referred to her family doctor, and one in nine had to be requested to return for a
repeat examination. From the wider "well woman" standpoint screening proved productive
irrespective of age, marital status, or size of family. The commonest incidental findings comprised
Trichomonas or Monilia infections, cervical erosions, cervical polyps, uterine fibroids, and various
forms of uterine prolapse.
Screening facilities for the general public are made available in Westminster to all women under
the age of 65 who live or work within the City boundaries. The policy of encouraging office workers
to be screened is strikingly endorsed by the results achieved in the case of one national concern.
An analysis of 641 employees of this body who attended for screening showed that three had
positive cervical smears, and a further 167 needed to be referred to their family doctors in relation
to other findings.
Notwithstanding the results achieved in 1968 there can be no grounds for complacency. Indeed,
although the screening sessions arranged at the Westminster Council House Extension (St.
Marlyebone) and the Ebury Bridge Maternal and Child Welfare Centres continued to be in great
demand throughout the year, being particularly conveniently situated for office workers, an
appreciable fall in attendance occurred in the autumn at the clinics held at the Hallfield and Harrow
Road Centres. This decline took place in spite of the liberal use of posters and leaflets in public
libraries, maternal and child welfare centres, and the staff rooms of private and public organisations.
Whilst recognising that an increasing number of women were being screened by their own general
practitioners, or during attendance at hospital outpatient departments or family planning clinics,
as well as in hospital wards, there could be no doubt that many had not yet taken advantage of this
new preventive weapon. To this end further encouragement of the public in general, and of the
local resident in particular, seemed desirable, and by the end of the year plans were already afoot
for an intensive publicity campaign to be launched in the north west part of the City early in 1969.
Finally, it is again a special pleasure to record the gratitude of the Health Department to the
consultant cytologists and their laboratory staffs at the Samaritan Hospital, the Chelsea Hospital for
Women, and St. Stephen's Hospital for the help willingly given during the year. Unfortunately,
staffing difficulties compelled the Chelsea Hospital for Women to cease examining the slides
obtained at Ebury Bridge towards the end of the summer; St. Stephen's Hospital in the Fulham Road
very kindly undertook this role until arrangements had been completed for these slides to be
examined at the Samaritan Hospital. Thanks to this generous assistance, the total number of women
screened since the inception of the service in September 1966 numbered 4,753 by the end of the
year, of whom 17 had been found to have positive cervical smears. An account of this service,
entitled "Cervical Screening and the Community" appeared in the March newsletter of the Women's
National Cancer Control Campaign—a voluntary organisation to the forefront of the national
endeavour to persuade women to be screened.