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Carcinoma-in-situ of the cervix: is post-hysterectomy cytology worthwhile?

The cytological records for the years 1950-1980 from South East Scotland revealed 1062 patients who had had histologically confirmed carcinoma-in-situ (or severe dysplasia) of the cervix at the time of hysterectomy. Ten cases of early 'recurrence' were detected in the first year of follow-up. During 4304 women-years of subsequent regular follow-up by vaginal vault smears, only one further confirmed recurrence was detected, this being a poorly differentiated squamous carcinoma in a 26-year-old patient, 4 years after hysterectomy. Two further patients not in regular follow-up presented clinically with invasive carcinoma. The implications for follow-up policies are discussed.