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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2023; 83(10): 1235-1249
DOI: 10.1055/a-2134-6740
GebFra Science
Original Article

Evaluations of the 2019 Annual Statistics Under the Cervical Cytology Quality Assurance Agreement

2019 Annual Statistics for Cervical Cytology from 15608413 Women Article in several languages: English | deutsch
Ulrich Schenck
1   Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München, München, Germany (Ringgold ID: RIN9184)
,
Heike Hantschke-Zerbich
2   Dezernat Versorgungsqualität, Kassenärztliche Bundesvereinigung KdöR, Berlin, Germany (Ringgold ID: RIN27649)
,
Frank Woellner
2   Dezernat Versorgungsqualität, Kassenärztliche Bundesvereinigung KdöR, Berlin, Germany (Ringgold ID: RIN27649)
,
Frank Michel
2   Dezernat Versorgungsqualität, Kassenärztliche Bundesvereinigung KdöR, Berlin, Germany (Ringgold ID: RIN27649)
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Abstract

Background

Cervical cancer screening, which was introduced into the programme of medical care covered by statutory health insurance in Germany in 1971 and has since been constantly updated through quality assurance measures, was fundamentally revised and developed in 2008 through the Cervical Cytology Quality Assurance Agreement pursuant to Section 135(2) of the German Social Code Book V [SGB V]. Since 2015 it has been mandatory for cytology facilities to record annual statistics based on the Munich Nomenclature III. The aim of this article is to present the results of the annual statistics for 2019, which was the last year before the introduction of the cervical cancer screening programme in accordance with the Federal Joint Committee’s guideline on organised cancer screening programmes [1].

Materials and Methods

The annual statistics of the laboratories, including histology analyses performed up until 30 June the following year, are reported to the Regional Associations of Statutory Health Insurance Physicians. The laboratories receive benchmark reports from their Regional Associations of Statutory Health Insurance Physicians, and these statistics are transmitted anonymously to the National Association of Statutory Health Insurance Physicians (KBV).

Results

In 2019, 17609082 smears from 15608413 women were examined in Germany. Of these smears, 97.49% were normal and 2.51% showed atypical or suspicious changes, consisting mostly of minor squamous epithelial changes in groups II-p (0.81%) and IIID1 (0.735%).

Histology specimens are available for “Dysplasia findings with higher probability of regression” in group IIID1 (4.89% of initial IIID1 cytology findings), group IIID2 (18.60%), “unclear or doubtful findings” in group III-p to x (20.7%), and “immediate precursors to cervical carcinoma” in group IV (83.1%) and group V (77.19%).

In the cytology findings for group IVa-p, which corresponds to CIN 3 target lesions, the cytology correlated with the histology finding in 80.48% of cases.

Lesions found in 2019: 23463 CIN 3 lesions, 668 adenocarcinomas in situ, 3891 malignant tumours, including 2342 cervical carcinomas of which 1743 were squamous cell carcinomas and 599 were cervical adenocarcinomas (25.57%); 1549 endometrial carcinomas and other malignancies.

Inference/Conclusion

The data demonstrate the good practicability of cervical cancer screening in 2019. Higher grade lesions were reliably clarified histologically.

Keywords

cervical cancer - precancerous cervical lesions - epidemiology - cervix - quality assurance - cytology


Publication History

Received: 18 April 2023

Accepted after revision: 20 July 2023

Article published online:
22 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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