The Consequences of Non-Participation and Inadequate Follow-up in Cervical Cancer Screening

Aims:.In 2020 in Germany, co-testing with Pap smear and HPV etection was introduced.In the present study, we retrospectively analyzed to which extent the women diagnosed with cervical cancer had participated in the national screening program.Additionally, we examined whether those who had undergone screening received appropriate follow-up care for abnormal findings. Methods:In 2024, 11 cervical cancers were diagnosed at our institute.The patients were from Germany, primarily northern regions.In all cases, the diagnosis was confirmed using histology.We retrospectively examined whether these women had participated in the German national cervical cancer screening program.Results: 8 out of 11 women had not undergone cytological and/or HPV testing in the years preceding their cancer diagnosis.Three women had previously received abnormal Pap smear (all classified as Pap III D1) and positive HPV results, but their findings were not followed up according to standard protocols.The average age at the time of cancer diagnosis was 55 years.Discussion: The significant reduction in cervical cancer incidence in Germany can be attributed to the successful early detection program.However, our study indicates two critical issues.On one side, the greater part of the affected women had not participated in the screening program prior to the diagnosis, when on the other side women who had undergone cytological and HPV testing, abnormal findings were not consistently followed up by colposcopy as recommended by standard protocols.Therefore, increasing the participation rate and securing consistent follow-up of abnormal findings should be prioritized to further reduce the incidence of cervical cancer.