The value of cytodiagnosis in cervix cancer precursors and the latency and progression of carcinoma in situ

The biological behaviour, the progression rate and the latency period of the carcinoma in situ of the cervix uteri are discussed. We have tried to find out this by concluding indirectly and evaluating epidemiologically our own material, and considering the literature. Between 1966 and 1982 we bioptically diagnosed 3.327 in situ and 1.653 invasive carcinomas. Among these there were 155 (9.4%) microcarcinomas. The annual average age of women with carcinomata in situ in the years 1973 to 1982 was between 35 and 40 years with tendency to younger groups. The average age of women with invasive carcinomas with the microcarcinoma excluded ranged from 51 to 59 years. The average age of 114 women with microcarcinomas during 1973 to 1982 was 47 years. The carcinoma in situ is a precursor of the invasive carcinoma in almost each case. The progression rate is approximately 30 to 50%. The period of latency from carcinoma in situ to microcarcinoma amounts to 7 to 10 years on the average, to clinically manifest invasive carcinoma 10 to 15 years. A reliable prognosis is impossible for the individual case. After the establishment of a cytological department at the Pathological Institute Schwerin in 1968 the annual number of cytological examinations has increased to 74,000 women in 1982 (approximately 40% of women over 20 years; 50% of women between 20 and 60 years). The incidence of invasive cervical carcinoma decreased from 1969 to 1982 from 38.9 to 20.7 per 100,000 (53% of the initial figure). The mortality decreased from 25.1 to as little as 9.7 per 100,000 (39%).(ABSTRACT TRUNCATED AT 250 WORDS)