Skip to main content
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 1988 Dec;79(12):1269–1275. doi: 10.1111/j.1349-7006.1988.tb01555.x

A Case‐Control Study of the Effectiveness of Cervical Cancer Screening in Osaka, Japan

Tomotaka Sobue 1,, Takaichiro Suzuki 1, Sumiyo Hashimoto 2, Nobuko Yokoi 3, Isaburo Fujimoto 1
PMCID: PMC5917660  PMID: 3148596

Abstract

In the small town of Nose in Osaka, Japan, a population‐based screening program for cervical cancer by Papanicolaou smear has been conducted since 1965. In order to evaluate the effectiveness of screening in terms of the reduction of the mortality and the incidence of invasive cervical cancer, two types of case‐control studies were carried out. In the first study, the case series consisted of all women who died of cervical cancer under 80 years of age at the time of diagnosis in 1965‐1987 (N = 15). For each case, 10 controls were chosen from living residents, matched by year of birth. It showed that the odds ratio (OR) of dying of cervical cancer for screened versus non‐screened women was 0.22 (95%CI = 0.03‐1.95). In the second study, the case series consisted of all women who were diagnosed as having invasive cancer under 80 years of age at the time of diagnosis in the same period (N = 28). For each case, 10 controls were chosen from living residents without invasive cancer, matched by year of birth and according to whether or not they were screened at the year of the diagnosis of the matched case. It showed that the OR of getting invasive cancer for screened versus non‐screened women was 0,41 (95%CI = 0.13‐1.29). From these results, it was estimated that 78% of cervical cancer mortality and 59% of invasive cervical cancer incidence among non‐screened women could be prevented by cervical cancer screening.

Keywords: Cervical cancer, Screening, Effectiveness, Case‐control study

Full Text

The Full Text of this article is available as a PDF (364.0 KB).

References

  • 1. ) Health and Welfare Statistics Association “ Health and Welfare Statistics in Japan ” ( 1986. ). Tokyo . [Google Scholar]
  • 2. ) Miller , A. B. , Lindsay , J. and Hill , G. B.Mortality from cancer of the uterus in Canada and its relationship to screening for cancer of the cervix . Int. J. Cancer , 17 , 602 – 612 ( 1976. ). [DOI] [PubMed] [Google Scholar]
  • 3. ) Johannesson , G. , Geirsson , G. , Day , N. and Tulinius , H.Screening for cancer of the uterine cervix in Iceland 1965–1978 . Acta Obstet. Gynecol. Scand. , 61 , 199 – 203 ( 1982. ). [DOI] [PubMed] [Google Scholar]
  • 4. ) Lynge , E.Regional trends in incidence of cervical cancer in Denmark in relation to local smear‐taking activity . Int. J. Epidemiol. , 12 , 405 – 413 ( 1983. ). [DOI] [PubMed] [Google Scholar]
  • 5. ) Stenkvist , B. , Bergstroem , R. , Eklund , G. and Fox , C. H.Papanicolaou smear screening and cervical cancer . J. Am. Med. Assoc. , 252 , 1423 – 1426 ( 1984. ). [PubMed] [Google Scholar]
  • 6. ) Hakama , M.Effect of population screening for carcinoma of the uterine cervix in Finland . Maturitas , 7 , 3 – 10 ( 1985. ). [DOI] [PubMed] [Google Scholar]
  • 7. ) Duguid , H. L. D. , Duncan , I. D. and Currie , J.Screening for cervical intraepithelial neoplasia in Dundee and Angus 1962–81 and its relation with invasive cervical cancer . Lancet ii , 1053 – 1056 ( 1985. ). [DOI] [PubMed] [Google Scholar]
  • 8. ) van der Graaf , Y. , Klinkhamer , P. J. J. M. and Vooijs , G. P.Effect of population screening for cancer of the uterine cervix in Nijmegen, The Netherlands . Prev. Med. , 15 , 582 – 590 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 9. ) Clarke , E. A. and Anderson , T. W.Does screening by “Pap” smears help prevent cervical cancer? A case‐control study . Lancet ii , 1 – 4 ( 1979. ). [DOI] [PubMed] [Google Scholar]
  • 10. ) Aristizabal , N. , Cuello , C. , Correa , P. , Collazos , T. and Haenszel , W.The impact of vaginal cytology on cervical cancer risks in Cali, Colombia . Int. J. Cancer , 34 , 5 – 9 ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 11. ) La Vecchia , C. , Decarli , A. , Gentile , A. , Fanceschi , S. , Fasoli , M. and Tognoni , G.“Pap” smear and the risk of cervical neoplasia: quantitative estimates from case‐control study . Lancet ii , 779 – 782 ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 12. ) van der Graaf , Y. , Zielhuis , G. A. , Peer , P. G. M. and Vooijs , P. G.The effectiveness of cervical screening: a population‐based case‐control study . J. Clin. Epidemiol. , 41 , 21 – 26 ( 1988. ). [DOI] [PubMed] [Google Scholar]
  • 13. ) Macgregor , J. E. , Moss , S. M. , Parkin , D. M. and Day , N. E.A case‐control study of cervical cancer screening in north east Scotland . Br. Med. J. , 290 , 1543 – 1546 ( 1985. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14. ) Sasco , A. J. , Day , N. E. and Walter , S. D.Case‐control studies for the evaluation of screening . J. Chron. Dis. , 39 , 399 – 405 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 15. ) Yajima , A. , Mori , T. , Sato , S. , Wakisaka , T. and Suzuki , M.Effect of cytologic screening on the detection of cervical carcinoma . Obstet. Gynecol. , 59 , 565 – 568 ( 1982. ). [PubMed] [Google Scholar]
  • 16. ) Kusanagi , T. , Kudo , R. , Ito , E. , Sagae , S. , Hori , Y. , Tamura , H. , Hayakawa , O. , Fujimura , Y. and Hashimoto , M.Studies on the appropriate interval of mass screening for cervical cancer . Acta Obstet. Gynaecol. Jpn. , 35 , 782 – 786 ( 1983. ) ( in Japanese ). [PubMed] [Google Scholar]
  • 17. ) Iwanari , O.Appropriate frequency of mass‐screening for uterine cervical cancer . Acta Obstet. Gynaecol. Jpn. , 39 , 1799 – 1805 ( 1987. ). [PubMed] [Google Scholar]
  • 18. ) Takahashi , K. , Moriyama , M. , Takamiya , O. , Shibukawa , T. , Iwanari , O. , Matsunaga , K. and Kitao , M.Studies of screening, detection and mortality rates in mass‐screening for uterine cervical cancer in Shimane Prefecture . Acta Obstet. Gynaecol. Jpn. , 37 , 377 – 382 ( 1985. ) ( in Japanese ). [PubMed] [Google Scholar]
  • 19. ) Yajima , A. , Higashiiwai , H. , Sato , A. , Watanabe , M. , Hoshi , K. , Mori , T. , Yonemoto , Y. , Suzuki , M. and Noda , K.Mass population screening for cervical cancer in Miyagi Prefecture . Gynecol. Oncol. , 8 , 131 – 140 ( 1979. ). [DOI] [PubMed] [Google Scholar]
  • 20. ) Kuroishi , T. , Hirose , K. and Tominaga , S.Evaluation of the efficacy of mass screening for uterine cancer in Japan . Jpn. J. Cancer Res. (Gann) , 77 , 399 – 405 ( 1986. ). [PubMed] [Google Scholar]
  • 21. ) Oshima , A. , Hirata , N. , Ubukata , T. , Umeda , K. and Fujimoto , I.Evaluation of a mass screening program for stomach cancer with a case‐control study design . Int. J. Cancer , 38 , 829 – 833 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 22. ) Naessens , J. M. , Offord , K. P. , Scott , W. F. and Daood , S. L.The MCSTRAT Procedure . In “ SUGI Supplemental Library User's Guide, Version 5 Edition ,” pp. 307 – 328 ( 1986. ). SAS Institute; , Cary , NC . [Google Scholar]
  • 23. ) Hulka , B. S.Risk factors for cervical cancer . J. Chron. Dis. , 35 , 3 – 11 ( 1982. ). [DOI] [PubMed] [Google Scholar]
  • 24. ) Berg , J. W. and Lampe , J. G.High‐risk factors in gynecologic cancer . Cancer , 48 , 429 – 441 ( 1981. ). [DOI] [PubMed] [Google Scholar]
  • 25. ) Brinton , L. A. , Schairer , C. and Haenszel , W.Cigarette smoking and invasive cervical cancer . J. Am. Med. Assoc. , 255 , 3265 – 3269 ( 1986. ). [PubMed] [Google Scholar]
  • 26. ) Parkin , D. M. , Collins , W. and Clayden , A. D.Cytology screening in two Yorkshire areas: patterns of service . Public Health , 95 , 311 – 321 ( 1981. ). [DOI] [PubMed] [Google Scholar]
  • 27. ) Kato , I. and Tominaga , S.Characteristics of participants of uterine cancer screening test . Jpn. J. Public Health , 34 , 748 – 754 ( 1987. ) ( in Japanese ). [Google Scholar]
  • 28. ) Gunby , P.Compromise reached on tests on suggested intervals between Pap (medical news) . J. Am. Med. Assoc. , 26 , 1411 – 1413 ( 1980. ). [PubMed] [Google Scholar]
  • 29. ) The International Academy of Cytology . The International Academy of Cytology's policy statement on the frequency of gynecologic screening . Acta Cytol. , 24 , 371 – 372 ( 1980. ). [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES