{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:51:04Z","timestamp":1758801064348,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1994,1]]},"abstract":"<jats:p>AIMS--To ascertain the type and relative frequency of major factors associated with deaths from cervical cancer. METHODS--Deaths from cervical cancer in Rotherham district for the period 1989-1991 were subjected to multifactorial audit by reviewing laboratory, hospital, and general practitioner records; together with, when appropriate, re-screening of cytology smears. This period represented the three to five years after a computerised National Screening Programme (NSP) had been implemented with a five year recall interval. RESULTS--Thirty six deaths were identified. The average age of death was 59 years with 39% occurring in those over 65. Only 6% of cases presented as a result of a cervical smear, comprising 3% derived from the NSP and 3% by chance. Forty seven per cent of cases in which the patient had died had no record of a previous smear invitation; 22% of patients were under 65 years and 25% 65 or over. Those under 65 had presented before the appropriate age band had been called. A non-response to a cervical smear invitation was identified in 22%. In 25% of cases a true negative smear had been reported one to eight years previously (average 4.8 years). An inappropriate laboratory diagnosis was identified in 17% of cases. Fourteen per cent represented false negative smears and 8% comprised inadequate smears that had been reported as negative. Inappropriate clinical diagnosis or management was identified in 19% of cases. In 22% two or more contributory factors were identified in the same patient. CONCLUSIONS--Areas highlighted by the audit warranting further attention included the targeting of women over 65 with no cytology record; those not responding to smear invitations; laboratory performance; clinical acumen; and the reasons for true negative cervical smears. Multifactorial audit of all deaths from cervical cancer should be advocated nationally to assess and improve the effectiveness of the NSP.<\/jats:p>","DOI":"10.1136\/jcp.47.1.27","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"27-28","source":"Crossref","is-referenced-by-count":27,"title":["Audit of deaths from cervical cancer: proposal for an essential component of the National Screening Programme."],"prefix":"10.1136","volume":"47","author":[{"given":"D N","family":"Slater","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P C","family":"Milner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Radley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0140-6736(90)90552-G","article-title":"Screening for cancer of the cervix in elderly women","volume":"335","author":"Fletcher, A.","year":"1990","unstructured":"Fletcher A. Screening for cancer of the cervix in elderly women. Lancet 1990;335:97-9.","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1136\/bmj.300.6740.1622","article-title":"Cervical cancers diagnosed after negative results on cervical cytology: perspective in the 1980's","volume":"300","author":"Mitchell, H.; Medley, G.; Giles, G.","year":"1990","unstructured":"Mitchell H, Medley G, Giles G. Cervical cancers diagnosed after negative results on cervical cytology: perspective in the 1980's. BMJ 1990;300:1622-4.","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1136\/bmj.296.6628.1041","article-title":"Invitation of non responders at a cervical cancer screening clinic in","volume":"296","author":"Nathoo, V.","year":"1988","unstructured":"Nathoo V. Invitation of non responders at a cervical cancer screening clinic in Manchester. Br Med J 1988; 296:1041-2.","journal-title":"Manchester. Br Med J"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1365-2303.1992.tb00029.x","article-title":"An audit of cervical cancer deaths in Nottingham","volume":"3","author":"Wilson, S.H.; Johnson, J.","year":"1992","unstructured":"Wilson SH, Johnson J. An audit of cervical cancer deaths in Nottingham. Cytopathology 1992;3:79-84.","journal-title":"Cytopathology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1136\/bmj.289.6449.896","article-title":"Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire","volume":"289","author":"Patterson, M.E.L.; Peel, A.R.; Joslin, C.A.F.","year":"1984","unstructured":"Patterson MEL, Peel AR, Joslin CAF. Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire. Br MedJ 1984;289:896-8.","journal-title":"Br MedJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1136\/bmj.289.6449.891","article-title":"Are patients with abnormal cervical smears adequately managed?","volume":"289","author":"Elwood, J.M.; Cotton, R.E.; Johnson, J.; Jones, G.M.; Curnow, J.; Beaver, M.W.","year":"1984","unstructured":"Elwood JM, Cotton RE, Johnson J, Jones GM, Curnow J, Beaver MW. Are patients with abnormal cervical smears adequately managed? Br Medy 1984;289:891-4.","journal-title":"Br Medy"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.47.1.27","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:12:29Z","timestamp":1758798749000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.47.1.27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,1]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1994,1,1]]},"published-print":{"date-parts":[[1994,1]]}},"alternative-id":["10.1136\/jcp.47.1.27"],"URL":"https:\/\/doi.org\/10.1136\/jcp.47.1.27","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[1994,1]]}}}