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Age trends in Pap smear usage, 1971-1986.

Age specific rates for Papanicolaou smears by the Victorian Cytology (Gynaecological) Service (VCGS) during 1971 to 1986 are presented. There was a dramatic increase in smear rates for women aged less than 35 years during the period studied. 
 
 
 
Conversely, for postmenopausal women maximum smear rates were achieved in 1971 with a steady decline thereafter. In women over the age of 55 years, the 1986 smear rates were approximately half the 1971 rates. The pronounced decline in smear rates in older women is particularly worrying as these women constitute the age group with the highest incidence rates for cervical cancer. 
 
 
 
The highest rate for any age group occurred in 1976 when 357 women per 1000 female residents in the age group 35–39 years were screened. Smears were received from an estimated 18.3 percent of the resident female population of Victoria during 1986. A longitudinal study of subsequent use of cervical cytology by women having negative smears in 1971 is in progress.