Use of pap-smears in a population without a mass screening program.

Study Objective: To analyze the use of Pap-smears in a population where a screening program was not offered.

Design: Retrospective analysis of pathology registry data on women resident in two counties of Norway.

Setting: Evaluation of opportunistic screening by age and year of birth. Proportion of population tested during successive 3-year periods.

Material: 353,665 smears from 88,048 women examined since 1973. For this purpose we concentrated on 257,951 smears from 77,431 women examined during the period 1981-90.

Results: Between 62 and 67% of women examined during each 3-year period were 20-39 years old, 14-16% were 50-69 years of age. Throughout the ten-year period the frequency of Pap-smear testing of women over 60 and under 20 increased slightly whereas it decreased for women 20-39 years old. Follow-up of positive or atypical smears comprised about 25% of all smears. The highest proportion of follow-ups was found among women 30-49 years old. About one third of women aged 20-59 years had more than one smear taken in a 3-year period, follow-up smears excluded.

Conclusion: More than half of the women aged 50 and above have no smears or smears less than one every third year. This proportion increases with age. The use and distribution of smears by age is still far from the situation expected in an organized screening program although a slight amelioration was observed through the study period.