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Making the most of Pap tests
  1. Department of Public Health, A27 University of Sydney, Sydney, NSW, Australia 2006

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    The paper by Taylor and colleagues1 in this issue of the journal indicates that in NSW, (a state of Australia with a population of approximately 2.4 million adult women2), cervical cancer screening prevented the development of around 3400 cases of cervical cancer between 1972 and 1996. Projections of the population, cervical cancer incidence and effectiveness of screening to 2006 suggest that close to 8000 cases of cervical cancer will be prevented by 2006. Their analysis indicates that in the interval 1972–1996, 1200–1600 deaths from cervical cancer were averted.

    As Taylor et al note there are no randomised trials of cervical cancer screening so individuals and organisations wishing to quantify the effectiveness of screening are forced to rely on observational data examining trends in incidence and mortality in relation to the introduction and intensity of screening programmes. Recent papers3-5 are consistent with Tayloret al in demonstrating an impact of screening over the past decade and add to the body of observational literature indicating that cervical cancer screening does indeed work. For example, using mortality data from England and Wales, Sasieni and Adams estimate that there were about 8000 fewer cervical cancer deaths between 1988 and 1997 as a result of screening.3

    Cervical cancer screening has made an important impact on women's health. But that is not to say …

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