Browsing by Author "Smith, N"

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    Challenges to cervical screening in the Western Cape province
    (2003) Smith, N; Moodley, J R; Hoffman, M
    Carcinoma of the cervix is the second most common cancer among South African women, with 1 in 41 women developing the disease in her lifetime.1 Although population-based screening programmes using Pap smears can substantially decrease the incidence of the disease, such programmes remain remarkably difficult to implement. Lack of resources and available treatment, low community awareness, poor quality of Pap smears, and inadequate rates of follow-up are foremost among the documented obstacles to successful cytological screening.2,3 In South Africa, work to develop a nationwide screening programme has been ongoing, culminating in 1999 in the release of a national cervical screening policy.4 The screening protocol is based on World Health Organisation (WHO) recommendations for regions with limited resources5 and models of the natural history of the disease.6 The incidence of invasive cancer in South Africa begins to rise for women between the ages of 35 and 39 years, with 87% of cases occurring in women over 35.1 A lifetime total of three Pap smears, taken at 10-year intervals, is to be made available free to all women aged over 30 years, with follow-up and treatment for abnormal tests also free. The goal is to screen 70% of women in the target age group within 10 years of initiating the programme. Screening and treatment based on this model should theoretically decrease cancer incidence by 64%.