Discovering asymptomatic non-precancerous lesions with cervical cytologic mass-screening campaigns: is it a benefit or a cost?

A total of 3357 women (88.1% married, 82.0% parous) were examined at least once in the mass-screening program carried out by the Legnano Hospital Screening Center in Nerviano (a small town near Milan with 15,600 inhabitants) in 1974, 1977 and 1980. Married women with visible portio and adequate smear were 2758: a visibly healthy cervix was found only in 1143 subjects (41.4%). A total of 1516 married women were examined at least in 2 consecutive campaigns: 1279 (84.4%) reported "no gynecologic treatment in the previous 5 years" at the first campaign, and 899 (59.3%) reported "no gynecologic treatment in the previous 3 years" at their second one. Of 350 women with "medical lesions" and 525 with "surgical lesions" recorded at the first visit, 111 (31.7%) and 232 (44.2%) reported, respectively, a "medical treatment" or a "surgical treatment" at the second visit. In women with "medical lesions" at the first visit, at the second visit a healthy cervix was found in 66.2% of the treated women and in 72.6% of the untreated patients. In those with "surgical lesions" a healthy cervix was successively found in 91.6% of treated and in 40.7% of the untreated patients.