Morbidity From Cervical Cancer: Effects of Cervical Cytology and Socioeconomic Status2

Abstract

The rates of newly diagnosed cases of invasive cancer of the cervix uteri are presented for Louisville and Jefferson County, Kentucky, for an 11-year period. A 3-year precytology period, 1953–55, with an age-adjusted rate of 33.8 per 100,000 females, served as a baseline. During the next 3 years, which encompassed the onset of mass cytologic screening, the rates rose to 40.3, an increase of 19.2 percent. During the next 4 years, the rates approximated those of the precytology period. Data for 1963 indicated a 22.7 percent reduction of the invasive cervical cancer rate. The proportion of cases in clinical stage I increased, the rise being much greater for the cases detected cytologically when compared with other cases. For 1959–62, a reduction of 43 percent was recorded for stages II through IV among white women under 50 years of age. In all years studied, there was a marked association between the development of cervical cancer in the Caucasian race living in a lower socioeconomic area of Louisville. Nonwhite rates were similar to white rates in the lowest socioeconomic area. The increased number of cases early in the mass-screening program and the need for future observations to evaluate the effectiveness of cytologic screening are discussed.